Australian Diabetes Foot Network, Australian Diabetes Society, Sydney, Australia.
J Foot Ankle Res. 2013 Feb 26;6(1):6. doi: 10.1186/1757-1146-6-6.
Trauma, in the form of pressure and/or friction from footwear, is a common cause of foot ulceration in people with diabetes. These practical recommendations regarding the provision of footwear for people with diabetes were agreed upon following review of existing position statements and clinical guidelines. The aim of this process was not to re-invent existing guidelines but to provide practical guidance for health professionals on how they can best deliver these recommendations within the Australian health system. Where information was lacking or inconsistent, a consensus was reached following discussion by all authors. Appropriately prescribed footwear, used alone or in conjunction with custom-made foot orthoses, can reduce pedal pressures and reduce the risk of foot ulceration. It is important for all health professionals involved in the care of people with diabetes to both assess and make recommendations on the footwear needs of their clients or to refer to health professionals with such skills and knowledge. Individuals with more complex footwear needs (for example those who require custom-made medical grade footwear and orthoses) should be referred to health professionals with experience in the prescription of these modalities and who are able to provide appropriate and timely follow-up. Where financial disadvantage is a barrier to individuals acquiring appropriate footwear, health care professionals should be aware of state and territory based equipment funding schemes that can provide financial assistance. Aboriginal and Torres Strait Islanders and people living in rural and remote areas are likely to have limited access to a broad range of footwear. Provision of appropriate footwear to people with diabetes in these communities needs be addressed as part of a comprehensive national strategy to reduce the burden of diabetes and its complications on the health system.
创伤,以鞋子的压力和/或摩擦力的形式,是糖尿病患者足部溃疡的常见原因。这些关于为糖尿病患者提供鞋子的实用建议是在审查现有立场声明和临床指南后达成的。这一过程的目的不是重新发明现有的指南,而是为卫生专业人员提供如何在澳大利亚卫生系统中最好地提供这些建议的实用指导。在信息缺乏或不一致的情况下,在所有作者讨论后达成共识。适当的处方鞋,单独使用或与定制足矫形器一起使用,可降低足底压力并降低足部溃疡的风险。所有参与糖尿病患者护理的卫生专业人员都要评估并为其客户的鞋子需求提出建议,或转介具有此类技能和知识的卫生专业人员。对鞋子有更复杂需求的人(例如,需要定制医疗级鞋子和矫形器的人)应转介给有处方这些方法经验并能够提供适当和及时随访的卫生专业人员。如果经济困难是个人获得合适鞋子的障碍,医疗保健专业人员应了解可提供经济援助的州和地区的设备资助计划。原住民和托雷斯海峡岛民以及居住在农村和偏远地区的人可能难以获得广泛的鞋子选择。为这些社区的糖尿病患者提供合适的鞋子需要作为减少糖尿病及其并发症对卫生系统负担的综合国家战略的一部分来解决。