Current challenges and opportunities in the prevention and management of diabetic foot ulcers.
Open accessAbstract
Diabetic foot ulcers remain a major health care problem. They are common, result in considerable suffering, frequently recur, and are associated with high mortality, as well as considerable health care costs. While national and international guidance exists, the evidence base for much of routine clinical care is thin. It follows that many aspects of the structure and delivery of care are susceptible to the beliefs and opinion of individuals. It is probable that this contributes to the geographic variation in outcome that has been documented in a number of countries. This article considers these issues in depth and emphasizes the urgent need to improve the design and conduct of clinical trials in this field, as well as to undertake systematic comparison of the results of routine care in different health economies. There is strong suggestive evidence to indicate that appropriate changes in the relevant care pathways can result in a prompt improvement in clinical outcomes.
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Two national surveys of clinicians in the United States and Australia show that the total contact cast was used in only 2% and 15% of patients, respectively, as a primary means of off-loading.
“Two national surveys of clinicians in the United States and Australia show that the total contact cast was used in only 2% and 15% of patients, respectively, as a primary means of off-loading.56,57”
From Diabetic Foot Ulcers (2023) · cites this paper as [57]
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- Authors
- Jeffcoate, W. J., Vileikyte, L., Boyko, E. J., Armstrong, D. G., & Boulton, A. J. M.
- Affiliations
- Nottingham University Hospitals NHS Trust (GB)
- Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, U.K., and Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, FL
- VA Puget Sound Health Care System (US)
- University of Southern California (US)
- University of Miami (US)
- Corresponding author
- Jeffcoate, William J.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2018-03-12
- Volume
- 41
- Issue
- 4
- Pages
- 645-652
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2790092059
- Cited by
- 475
- References
- 73
- Citations by year
- 2026: 45 · 2025: 51 · 2024: 60 · 2023: 60 · 2022: 74 · 2021: 65 · 2020: 59 · 2019: 52 · 2018: 9
- FWCI
- 7.12
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
- Health Sciences › Medicine › Dermatology › Skin Diseases and Diabetes
- Health Sciences › Medicine › Rehabilitation › Wound Healing and Treatments
- Keywords
- diabetic foot ulcer, ulcer prevention, ulcer treatment, regional variation in outcomes, clinical trial design, care pathways, routine clinical practice, health care costs, mortality
- MeSH terms
- Delivery of Health Care, Geography, Humans, Preventive Medicine, Incidence, Treatment Outcome, Health Care Costs, Diabetic Foot, Critical Pathways, Quality Improvement
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