Preventive foot care and reducing amputation: a step in the right direction for diabetes care

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Across the world, diabetic foot complications are increasing in prevalence and are associated with high morbidity and mortality. Approximately 40–60% of all lower extremity nontraumatic amputations in the world are carried out on patients with diabetes. Combined strategies of prevention, close monitoring of patients, multidisciplinary treatment of foot ulcers and education of the patients with diabetes, as well as healthcare providers, can lead to significant reductions in amputation rates by up to 85%. Education about foot care is the most important intervention for the prevention of amputation. It should be targeted at both patients with diabetes and healthcare workers. For improving the outcome of diabetic foot patients it is important to have a multidisciplinary approach in the management of diabetic foot ulcers, and empowering patients with diabetes to take better care of their feet is an important component of patient education. One of the programs mentioned in this article in detail as an illustrated example of education is the Step-by-Step Diabetic Foot Project, which was piloted and carried out in Tanzania and India. Importantly, the project was found to be associated with over a 50% reduction in amputation rates in Tanzania. Education is a powerful tool for both healthcare workers and patients in reducing amputation rates and can be achieved through a trained diabetes workforce working in an effective system of health. The Step-by-Step Diabetic Foot Project serves as a working model to reduce mortality and morbidity and improve patient outcomes by teaching health worker and patients about early detection and treatment of diabetic foot complications.

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