Organization of a Diabetic Foot Care Team

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The Diabetic Foot

Part of the book series: Contemporary Diabetes ((CDI))

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Abstract

Diabetes is a multifaceted disease characterized by several comorbidities and complications. Patients with lower extremity complications, i.e., peripheral vascular disease and ulcerations, may also suffer from chronic renal disease, cardiac disease, or gastrointestinal disturbances which will all affect the management of their foot problem. For this reason, a multidisciplinary team to manage these comorbid complications is essential even when patients are admitted for seemingly unrelated conditions. This chapter will begin with a historical perspective of the team approach as developed at the New England Deaconess Hospital and will then proceed to the currently prevailing concepts and evidence for the establishment of a successful foot care unit to manage these diabetic lower extremity conditions.

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References

  1. IDF diabetes atlas. 10th edn. 2021.

    Google Scholar 

  2. Fast facts: data and statistics about diabetes. ADA; 2015.

    Google Scholar 

  3. NCD Risk Factor Collaboration. Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet. 2016;387:1513–30.

    Article  Google Scholar 

  4. Lobstein T, Jackson-Leach R, Moodie ML, Hall KD, Gortmaker SL, Swinburn BA, James WPT, Wang Y, McPherson K. Child and adolescent obesity: part of a bigger picture. Lancet. 2015;385:2510–20.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Patterson C, Guariguata L, Dahlquist G, Soltesz G, Ogle G, Silink M. Diabetes in the young—a global view and worldwide estimates of numbers of children with type 1 diabetes. Diabetes Res Cl Pract. 2014;103:161–75.

    Article  Google Scholar 

  6. TODAY Study Group. Rapid rise in hypertension and nephropathy in youth with type 2 diabetes. Diabetes Care. 2013;36:1735–41.

    Article  PubMed Central  Google Scholar 

  7. Ginter E, Simko V. Type 2 diabetes mellitus, pandemic in the 21st century. Adv Exp Med Biol. 2012;771:42–50.

    Article  PubMed  Google Scholar 

  8. Sanders LJ, Robbins JM, Edmonds ME. History of the team approach to amputation prevention: pioneers and milestones. J Vasc Surg. 2010;52(15):3S–16S.

    Article  PubMed  Google Scholar 

  9. Gottrup F. A specialized wound-healing center concept: importance of a multidisciplinary department structure and surgical treatment facilities in the treatment of chronic wounds. Am J Surg. 2004;187:38S–43S.

    Article  PubMed  Google Scholar 

  10. Steed DL, Edington H, Moosa HH, Webster MW, Strauch GO, Baker WH, Mueller CB, Foise JR. Organization and development of a university multidisciplinary wound care clinic. Surgery. 1993;114(4):775–9.

    CAS  PubMed  Google Scholar 

  11. Edmonds ME, Blundell MP, Morris ME, Thomas EM, Cotton LT, Watkins PJ. Improved survival of the diabetic foot: the role of a specialized foot clinic. Q J Med. 1986;60(232):763–71.

    CAS  PubMed  Google Scholar 

  12. Matricali GA, Dereymaeker G, Muls E, Flour M, Mathieu C. Economic aspects of diabetic foot care in a multidisciplinary setting: a review. Diabetes Metab Res Rev. 2007;23(5):339–47.

    Article  PubMed  Google Scholar 

  13. Rubio JA, Aragon-Sanchez J, Jimenez S, et.al. Reducing major lower extremity amputations after the introduction of a multidisciplinary team for the diabetic foot. Int J Lower Ext Wounds 13(1):22–26, 2014.

    Google Scholar 

  14. Papazian HZ. An overview of the podiatry service and podiatry residency program at the New England deaconess hospital. The Hospital Podiatr. 1977;12(10):7–9.

    Google Scholar 

  15. McKittrick LS, McKittrick JB, Risley TS. Transmetatarsal amputation for infection or gangrene in patients with diabetes mellitus. Ann Surg. 1949;130(4):826–42.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Rosenblum BI, Pomposelli FB Jr, Giurini JM, Gibbons GW, Freeman DV, Chrzan JS, Campbell DR, Habershaw GM, LoGerfo FW. Maximizing foot salvage by a combined approach to foot ischemia and neuropathic ulceration in patients with diabetes. A 5-year experience. Diabetes Care. 1994;17(9):983–7.

    Article  CAS  PubMed  Google Scholar 

  17. Van Gils CC, Wheeler LA, Mellstrom M, Brinton EA, Mason S, Wheeler CG. Amputation prevention by vascular surgery and podiatry collaboration in high-risk diabetic and nondiabetic patients: the operation desert foot experience. Diabetes Care. 1999;22:678–83.

    Article  PubMed  Google Scholar 

  18. Kim PJ, Attinger CE, Evans KK, Steinberg JS. Role of the podiatrist in diabetic limb salvage. J Vasc Surg. 2012;56(4):1168–72.

    Article  PubMed  Google Scholar 

  19. El Sakka K, Fassiadis N, Gambhir RPS, et al. An integrated care pathway to save the critically ischaemic diabetic foot. Int J Clin Pract. 2006;60(6):667–9.

    Article  PubMed  Google Scholar 

  20. Sumpio BE, Armstrong DG, Lavery LA, Andros G. The role of interdisciplinary team approach in the management of the diabetic foot. J Vasc Surg. 2010;51:1504–6.

    Article  PubMed  Google Scholar 

  21. Manu CA, Mustafa OG, Bates M, et al. Transformation of the multidisciplinary diabetic foot clinic into a multidisciplinary diabetic foot day unit: results from a service evaluation. Int J Extrem Wounds. 2014;13(3):173–9.

    Article  Google Scholar 

  22. Williams DT, Majeed MU, Shingler G, Akbar MJ, Adamson DG, Whitaker CJ. A diabetic foot service established by a department of vascular surgery: an observational study. Ann Vasc Surg. 2012;26(5):700–6.

    Article  PubMed  Google Scholar 

  23. Hamonet J, Verdie-Kessler C, Daviet JC, Denes E, et al. Evaluation of a multidisciplinary consultation of diabetic foot. Ann Phys Rehab Med. 2010;53:306–18.

    Article  CAS  Google Scholar 

  24. Brem H, Sheehan P, Rosenberg HJ, et al. Evidence-based protocol for diabetic foot ulcers. Plast Reconstr Surg. 2006;117(Suppl):193S–209S.

    Article  CAS  PubMed  Google Scholar 

  25. Rogers L, Andros G, Caporusso J, et al. Toe and flow: essential components and structure of the amputation prevention team. J Vasc Surg. 2010;52:23S–7S.

    Article  PubMed  Google Scholar 

  26. Schaper NC, van Netten JJ, Apelqvist J, et al. Practical guidelines on the prevention and management of diabetic foot disease. Diabetes Metab Res Rev. 2020;36(S1):e3266.

    Article  PubMed  Google Scholar 

  27. Hicks CW, Canner JK, Mathioudakis N, et al. Incidence and risk factors associated with ulcer recurrence among patients with diabetic foot ulcers treated in a multidisciplinary setting. J Surg Res. 2020;246:243–50.

    Article  CAS  PubMed  Google Scholar 

  28. Chung J, Modrall G, Ahn C, et al. Multidisciplinary care improves amputation-free survival in patients with chronic limb ischemia. J Vasc Surg. 2015;61:162–9.

    Article  PubMed  Google Scholar 

  29. Crane M, Werber B. Critical pathways approach to diabetic pedal infections in a multidisciplinary setting. J Foot Ankle Surg. 1999;38:30–3.

    Article  CAS  PubMed  Google Scholar 

  30. Armstrong D, Bharara M, White M, et al. The impact and outcomes of establishing an integrated interdisciplinary surgical team to care for the diabetic foot. Diabetes Metab Res Rev. 2012;28:514–8.

    Article  PubMed  Google Scholar 

  31. Musuuza J, Sutherland B, Kurter S, et al. A systematic review of multidisciplinary teams to reduce major amputations for patients with diabetic foot ulcers. J Vasc Surg. 2020;71:1433–46.

    Article  PubMed  Google Scholar 

  32. Ayada G, Edel Y, Burg A, et al. Multidisciplinary team led by internists improves diabetic foot ulceration outcomes a before-after retrospective study. Eur J Intern Med. 2021;94:64–8.

    Article  PubMed  Google Scholar 

  33. Martinez-Gomez D, Moreno-Carrillo M, Campillo-Soto A, et al. Reduction in diabetic amputations over 15 years in a defined Spain population. Benefits of a critical pathway approach and multidisciplinary team work. Rev Esp Quimioter. 2014;27:170–9.

    CAS  PubMed  Google Scholar 

  34. Gibbons G, Marcaccio E, Burgess A, et al. Improved quality of diabetic foot care, 1984 vs 1990. Reduced length of stay and costs, insufficient reimbursement. Arch Surg. 1993;128:576–81.

    Article  CAS  PubMed  Google Scholar 

  35. Kim C, Moon J, Chung S, et al. The changes of trends in the diagnosis and treatment of diabetic foot ulcer over a 10-year period: singe center study. Diabetes Metab J. 2018;42:308–19.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Joret M, Osman K, Dean A, et al. Multidisciplinary clinics reduce treatment costs and improve patient outcomes in diabetic foot disease. J Vasc Surg. 2019;70:806–14.

    Article  PubMed  Google Scholar 

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Correspondence to Thanh Dinh .

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Dinh, T., Rosenblum, B.I. (2024). Organization of a Diabetic Foot Care Team. In: Veves, A., Giurini, J.M., Schermerhorn, M.L. (eds) The Diabetic Foot. Contemporary Diabetes. Humana, Cham. https://doi.org/10.1007/978-3-031-55715-6_28

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  • DOI: https://doi.org/10.1007/978-3-031-55715-6_28

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  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-031-55714-9

  • Online ISBN: 978-3-031-55715-6

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