Diabetic foot care: prevention is better than cure

Patients receiving renal replacement therapy especially haemodialysis (HD) are at high risk of foot ulcers which can lead to amputation. With the increasing numbers of patients with diabetes now presenting with renal failure, renal nurses are in a pivotal position to educate patients and initiate and oversee good foot care. This paper describes the risk factors for these patients and discusses general care for prevention and treatment of these factors. Factors such as regular screening which can be done easily and effectively in an HD setting where patients attend regularly is the first method towards prevention. Care and treatment of foot wounds based on results from the author's unit are discussed. The creation of a diabetes care programme for the author's HD unit have resulted in a more holistic approach to the care of the patient with diabetes and renal disease with special attention to foot care, which in turn has lead to an improved standard of care and better management of the patients' diabetes. This paper discusses information from this programme offering a summary of risks and treatments to assist those caring for these patients.