The DOI matches its Crossref record; 138 of the 138 references it cites were found in a registry or an index.
Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update)
Open accessAbstract
The International Working Group on the Diabetic Foot (IWGDF) has published evidence‐based guidelines on the prevention and management of diabetic foot disease since 1999. This guideline is on the prevention of foot ulceration in persons with diabetes and updates the 2015 IWGDF prevention guideline. We followed the GRADE methodology to devise clinical questions and critically important outcomes in the PICO format, to conduct a systematic review of the medical‐scientific literature, and to write recommendations and their rationale. The recommendations are based on the quality of evidence found in the systematic review, expert opinion where evidence was not available, and a weighing of the benefits and harms, patient preferences, feasibility and applicability, and costs related to the intervention. We recommend to screen a person at very low risk for ulceration annually for loss of protective sensation and peripheral artery disease and persons at higher risk at higher frequencies for additional risk factors. For preventing a foot ulcer, educate the at‐risk patient about appropriate foot self‐care and treat any pre‐ulcerative sign on the foot. Instruct moderate‐to‐high risk patients to wear accommodative properly fitting therapeutic footwear, and consider instructing them to monitor foot skin temperature. Prescribe therapeutic footwear that has a demonstrated plantar pressure relieving effect during walking to prevent plantar foot ulcer recurrence. In patients that fail non‐surgical treatment for an active or imminent ulcer, consider surgical intervention; we suggest not to use a nerve decompression procedure. Provide integrated foot care for high‐risk patients to prevent ulcer recurrence. Following these recommendations will help health care professionals to provide better care for persons with diabetes at risk of foot ulceration, to increase the number of ulcer‐free days, and to reduce the patient and health care burden of diabetic foot disease.
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Citations
Cites
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008) · BMJ · doi:10.1136/bmj.39489.470347.ad · Cited by 23,305 · cited 2×
“careful weighing of the benefits and harms, patient preferences, and financial costs (resource utilization) related to the intervention or diagnostic method.(15,16) Based on these factors, we graded the strength of each recommendation as “strong” or “weak”, and for or against a particular intervention or diagnostic me…”
BackgroundMethodDiabetic foot ulcers and their recurrence
Armstrong, D. G., Boulton, A. J. M., & Bus, S. A. (2017) · New England Journal of Medicine · doi:10.1056/nejmra1615439 · Cited by 4,376
Self-citationPhysical activity/exercise and diabetes: A position statement of the American Diabetes Association
Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., Horton, E. S., Castorino, K., & Tate, D. F. (2016) · Diabetes Care · doi:10.2337/dc16-1728 · Cited by 2,991
Causal pathways for incident lower-extremity ulcers in patients with diabetes from two settings.
Reiber, G. E., Vileikyte, L., Boyko, E. J., del Aguila, M., Smith, D. G., Lavery, L. A., & Boulton, A. J. (1999) · Diabetes Care · doi:10.2337/diacare.22.1.157 · Cited by 1,103
Self-citationPractical Guidelines on the prevention and management of diabetic foot disease (IWGDF 2019 update)
Schaper, N. C., van Netten, J. J., Apelqvist, J., Bus, S. A., Hinchliffe, R. J., Lipsky, B. A., & IWGDF Editorial Board (2020) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3266 · Cited by 970
Self-citationAlonso-Coello, P., Oxman, A. D., Moberg, J., Brignardello-Petersen, R., Akl, E. A., Davoli, M., Treweek, S., Mustafa, R. A., Vandvik, P. O., Meerpohl, J., et al. (2016) · BMJ · doi:10.1136/bmj.i2089 · Cited by 814 · cited 2×
“careful weighing of the benefits and harms, patient preferences, and financial costs (resource utilization) related to the intervention or diagnostic method.(15,16) Based on these factors, we graded the strength of each recommendation as “strong” or “weak”, and for or against a particular intervention or diagnostic me…”
BackgroundMethodLipsky, B. A., Senneville, É., Abbas, Z. G., Aragón‐Sánchez, J., Diggle, M., Embil, J. M., Kono, S., Lavery, L. A., Malone, M., van Asten, S. A., et al. (2020) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3280 · Cited by 775
Self-citationKiefe, C. I., Allison, J. J., Williams, O. D., Person, S. D., Weaver, M. T., & Weissman, N. W. (2001) · JAMA · doi:10.1001/jama.285.22.2871 · Cited by 503
Skin Temperature Monitoring Reduces the Risk for Diabetic Foot Ulceration in High-risk Patients
Armstrong, D. G., Holtz-Neiderer, K., Wendel, C., Mohler, M. J., Kimbriel, H. R., & Lavery, L. A. (2007) · The American Journal of Medicine · doi:10.1016/j.amjmed.2007.06.028 · Cited by 437
Self-citationPreventing Diabetic Foot Ulcer Recurrence in High-Risk Patients
Lavery, L. A., Higgins, K. R., Lanctot, D. R., Constantinides, G. P., Zamorano, R. G., Athanasiou, K. A., Armstrong, D. G., & Agrawal, C. M. (2007) · Diabetes Care · doi:10.2337/dc06-1600 · Cited by 434
Self-citation
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Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review
van Netten, J. J., Price, P. E., Lavery, L. A., Monteiro‐Soares, M., Rasmussen, A., Jubiz, Y., Bus, S. A., & on behalf of the International Working Group on the Diabetic Foot (IWGDF) (2016) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.2701 · Cited by 422
Self-citationMicroenvironment‐Based Diabetic Foot Ulcer Nanomedicine
Huang, F., Lu, X., Yang, Y., Yang, Y., Li, Y., Kuai, L., Li, B., Dong, H., & Shi, J. (2023) · Advanced Science · doi:10.1002/advs.202203308 · Cited by 365
Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2023 update)
Bus, S. A., Sacco, I. C. N., Monteiro‐Soares, M., Raspovic, A., Paton, J., Rasmussen, A., Lavery, L. A., & van Netten, J. J. (2024) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3651 · Cited by 279
Self-citation12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Callaghan, B. C., Echouffo-Tcheugui, J. B., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s012 · Cited by 176
12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes—2023
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Gibbons, C. H., Giurini, J. M., Hilliard, M. E., et al. (2023) · Diabetes Care · doi:10.2337/dc23-s012 · Cited by 169
Metadata
- Authors
- Bus, S. A., Lavery, L. A., Monteiro‐Soares, M., Rasmussen, A., Raspovic, A., Sacco, I. C. N., van Netten, J. J., & on behalf of the International Working Group on the Diabetic Foot
- Venue
- Diabetes/Metabolism Research and Reviews
- Publisher
- Wiley
- Published
- 2020-03
- Volume
- 36
- Issue
- S1
- Pages
- e3269-e3269
- ISSN
- 1520-7552 (ISSN-L)
- 1520-7560
- OpenAlex
- W3011314192
- Cited by
- 517
- References
- 138
- FWCI
- 52.22
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Bus, S. A., Lavery, L. A., Monteiro‐Soares, M., Rasmussen, A., Raspovic, A., Sacco, I. C. N., van Netten, J. J., & on behalf of the International Working Group on the Diabetic Foot. (2020). Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update). Diabetes/Metabolism Research and Reviews. https://doi.org/10.1002/dmrr.3269
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