TPCH Professor leads new guidelines for diabetes-related foot disease

New Australian-based guidelines for diabetes-related foot disease have been released this month, set to change the course of health outcomes for people with foot disease.

From preventing hospitalisation to amputation, the new guidelines which have been co-authored by The Prince Charles Hospital Associate Professor Pete Lazzarini are set to reduce the burden of foot disease.

It is estimated that 300,000 Australians are at risk of developing diabetes-related foot disease each year, with approximately 5,000 requiring some form of amputation as a result.

Professor Lazzarini said the new guidelines, the first since 2011, were set to improve outcomes for patients through 98 recommendations.

“Diabetes-related foot disease is a leading cause of hospitalisation, amputation, and disability in Australia,” Prof Lazzarini said.

“Each year, around 50, 000 Australians are walking around with a diabetes-related foot ulcer and around half of those are infected at any one time.

“These new diabetes-related foot disease guidelines are the first new Australian guidelines since 2011 and we’ve got evidence now from studies right around the world that we can prevent half of the hospitalisations and amputations just by implementing guideline-based care.”

The guidelines at a glance:

The 98 recommendations made across six new guidelines for the general medical audience have been summarised in the MJA:

• prevention — screening, education, self-care, footwear, and treatments to prevent diabetic foot disease;
• classification — classifications systems for ulcers, infection, ischaemia and auditing;
• peripheral artery disease — examinations and imaging for diagnosis, severity classification, and treatments;
• infection — examinations, cultures, imaging and inflammatory markers for diagnosis, severity classification, and treatments;
• offloading — pressure offloading treatments for different ulcer types and locations; and
• wound healing — debridement, wound dressing selection

The changes include a new risk stratification system for screening of people without diabetes-related foot disease, with more specific self-monitoring, footwear prescription, surgical treatments and activity management practices for those at increased risk.

For people with diabetes-related foot disease, there are new ulcer, infection and peripheral artery disease classification systems, with more specific recommendations to resolve diabetes-related foot disease.

The full guidelines summary in the MJA can be found here.