A Survey: Who Manages the Diabetic Foot in India?

Diabetic foot is a major cause of morbidity and nontraumatic amputations in India. Despite national guidelines, care remains fragmented across specialties. This study aimed to examine the roles of various surgical specialists in diabetic foot care in India.

A web-based survey comprising 20 questions was distributed via WhatsApp to general, plastic, orthopaedic, and vascular surgeons across India. The survey assessed specialty involvement, interdisciplinary collaboration, procedural roles, availability of protocols, and awareness of newer techniques. Responses were analyzed using descriptive statistics.

A total of 126 surgeons responded: 50% were plastic surgeons, followed by general (25%), orthopaedic (16%), and vascular surgeons (9%). While 94% favored dedicated diabetic foot clinics, only 16% reported the presence of written institutional protocols. Plastic surgeons were the most commonly identified team leaders (83%) and were predominantly involved in wound coverage (97%). Vascular surgeons led in revascularization (86%) and orthopaedic surgeons in deformity correction (62%). Collaboration was highest with physicians (79%). Awareness of nerve transfer techniques was high (86%), but practice was limited.

The survey highlights strong support for multidisciplinary diabetic foot care but reveals widespread gaps in structured protocols and coordinated team roles. A national call to action is needed to implement unified, context-sensitive, team-based diabetic foot care pathways across health care levels.