The diabetic foot in 2015: an overview

Area of Science:

• Diabetology
• Podiatry
• Wound Care

Background:

• The diabetic foot, once neglected, now receives significant research attention.
• International organizations and meetings have advanced diabetic foot research and management.
• A substantial evidence base now exists for diabetic foot problem treatment.

Purpose of the Study:

• To review the current evidence and management strategies for diabetic foot complications.
• To highlight advancements in understanding and treating diabetic foot ulcers, infections, and Charcot neuroarthropathy.
• To emphasize the role of multidisciplinary approaches and specific treatments like offloading and negative-pressure wound therapy.

Main Methods:

• Literature review of evidence-based research on diabetic foot complications.
• Analysis of international guidelines and randomized controlled trials.
• Synthesis of current understanding regarding aetiopathogenesis and treatment efficacy.

Main Results:

• Education is most effective for foot ulcer incidence reduction within a multidisciplinary approach.
• Offloading is the primary treatment for plantar neuropathic foot ulcers.
• Negative-pressure wound therapy and hyperbaric oxygen therapy show promise for complex wounds.
• Antibiotic choice and wound dressings have varying efficacy, with no single superior option identified.
• Peripheral artery disease significantly impacts healing and amputation risk.
• The aetiopathogenesis of Charcot neuroarthropathy is still under investigation, requiring prompt offloading for suspected cases.

Conclusions:

• Diabetic foot care has evolved significantly, supported by a growing body of evidence.
• Multidisciplinary care, targeted treatments like offloading, and effective infection management are key.
• Further research is needed to fully elucidate Charcot neuroarthropathy aetiopathogenesis and optimize treatment strategies.