The diabetic foot: established and emerging treatments

The diabetic foot is a major cause of morbidity and mortality. The present review aims to outline current treatment options for this ghastly diabetic complication. Although considerable progress has been achieved over the past years, there is still a long way to go. Indeed, the International Working Group of the Diabetic Foot reported 2 years ago that a lower extremity was amputated every 30 seconds due to diabetes somewhere in the world. Established therapeutic modalities (revascularisation, casting and debridement) remain the cornerstone of management. At the same time, new treatments (e.g. growth factors, bioengineered skin substitutes, extracellular matrix proteins, etc.) are continuously being developed and explored to improve treatment. Nonetheless, it should not be underestimated that both new and old treatments must be incorporated in a prudent and zealous therapeutic strategy. Essentially, only multidisciplinary foot clinics have demonstrated that the reduction of amputation rates is feasible. The endeavour should be coupled with widespread education on the elementary rules to achieve both primary and secondary prevention.