Nursing Roles in Diabetic Foot Ulcer Prevention, Wound Management, and Digital Monitoring

Diabetic foot ulcers (DFUs) remain a major cause of infection, hospitalization, impaired quality of life, and non-traumatic lower-limb amputation among people with diabetes. Effective management requires coordinated prevention, structured foot-risk assessment, pressure offloading, wound care, infection surveillance, patient education, and multidisciplinary follow-up. This narrative review examines the nurse-led and nurse-supported components of contemporary DFU care. Nurses contribute through routine foot and wound assessment, reinforcement of preventive behaviors and treatment adherence, support for offloading, monitoring after debridement and advanced wound therapies, and early recognition of infection, ischemia, osteomyelitis, or clinical deterioration. Patient and caregiver education should be practical, individualized, and reinforced over time. Current evidence most consistently supports improvements in foot-care knowledge, self-management behavior, and healthcare-provider competence, whereas effects on ulcer recurrence, hospitalization, and amputation remain less certain. Digital technologies, including telemedicine, wearable sensors, mobile health platforms, and artificial intelligence-based wound assessment, may improve access to monitoring, communication, and early risk detection. However, their evidence base and clinical readiness vary, and improved monitoring does not necessarily translate into better healing or fewer amputations. Their usefulness depends on patient training, data quality, governance, timely professional review, and integration with safe referral pathways. Digital tools should therefore support, rather than replace, direct clinical assessment and multidisciplinary decision-making. Overall, nursing practice is essential for translating evidence-based DFU management into continuous, coordinated, and patient-centered care.