Department of Internal Medicine, Spaarne Ziekenhuis Hoofddorp, Spaarne Poort 1, Hoofddorp, 2134 TM, The Netherlands.
Diabetes Metab Res Rev. 2012 Feb;28 Suppl 1:112-5. doi: 10.1002/dmrr.2238.
The foot of diabetic patients can be affected by ulceration, infection, and gangrene and is a source of major morbidity and mortality; yet, it has been neglected by health-care services. In recent years, however, the level of interest and knowledge has grown considerably, with an improving evidence base for clinical practice and the development of international consensus and guidelines that define strategies for diagnosis and appropriate treatment. Nevertheless, there are numerous barriers to the implementation of universal good care, involving attitudes and beliefs of doctors, other health-care professionals, and patients, and the structure of health-care systems, which conspire to prevent diabetic patients from receiving the appropriate multidisciplinary care they desperately need. Before diabetic foot care reaches the level desired by specialists in the field, these many barriers must be recognized and overcome. Sound and cost-effective strategies need to be developed. Policymakers and health-care professionals should work together to remove the obstacles and facilitate the provision of adequate diabetic foot care. The effect of diabetic foot disease and amputations will only be reduced if sufficient attention is paid to the necessary preventive measures.
糖尿病患者的足部可能会受到溃疡、感染和坏疽的影响，是导致发病率和死亡率的主要原因；然而，医疗服务却忽视了这一问题。然而，近年来，人们对这一问题的兴趣和认识水平有了显著提高，临床实践的证据基础不断改善，并且制定了国际共识和指南，为诊断和适当治疗制定了策略。然而，实施普遍良好的护理存在许多障碍，涉及医生、其他医疗保健专业人员和患者的态度和信念，以及医疗保健系统的结构，这些因素共同导致糖尿病患者无法获得他们迫切需要的适当多学科护理。在糖尿病足护理达到该领域专家所期望的水平之前，必须认识到并克服这些众多障碍。需要制定合理且具有成本效益的策略。政策制定者和医疗保健专业人员应共同努力，消除障碍，为提供足够的糖尿病足护理提供便利。只有充分关注必要的预防措施，才能减少糖尿病足病和截肢的影响。
