Bus Sicco A, Monteiro-Soares Matilde, Game Fran, van Netten Jaap J, Apelqvist Jan, Fitridge Robert, Senneville Eric, Schaper Nicolaas C
Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Amsterdam Movement Sciences, Program Rehabilitation & Development, Amsterdam, the Netherlands.
Diabetes Metab Res Rev. 2024 Mar;40(3):e3656. doi: 10.1002/dmrr.3656. Epub 2023 May 14.
Diabetes-related foot disease is a major source of patient burden and societal costs. Investing in evidence-based international guidelines on diabetes-related foot disease is important to reduce this burden and costs, provided the guidelines are focused on outcomes important to key stakeholders and are evidence-based and properly implemented.
The International Working Group on the Diabetic Foot (IWGDF) has published and updated international guidelines since 1999. The 2023 updates were made using the Grading of Recommendations Assessment Development and Evaluation evidence-to-decision framework. This concerns formulating relevant clinical questions and important outcomes, conducting systematic reviews of the literature and meta-analyses where appropriate, completing summary of judgement tables, and writing recommendations that are specific, unambiguous and actionable, along with their transparent rationale.
We herein describe the development of the 2023 IWGDF Guidelines on the prevention and management of diabetes-related foot disease, which consists of seven chapters, each prepared by a separate working group of international experts. These chapters provide guidelines related to diabetes-related foot disease on prevention; classification of diabetes-related foot ulcer, offloading, peripheral artery disease, infection, wound healing interventions, and active Charcot neuro-osteoarthropathy. Based on these seven guidelines, the IWGDF Editorial Board also produced a set of practical guidelines. Each guideline underwent extensive review by the members of the IWGDF Editorial Board as well as independent international experts in each field.
We believe that the adoption and implementation of the 2023 IWGDF guidelines by healthcare providers, public health agencies, and policymakers will improve the prevention and management of diabetes-related foot disease, and subsequently reduce the worldwide patient and societal burden caused by this disease.
糖尿病相关足部疾病是患者负担和社会成本的主要来源。投资制定基于证据的糖尿病相关足部疾病国际指南对于减轻这种负担和成本很重要，前提是这些指南关注对关键利益相关者重要的结果，并且基于证据且得到妥善实施。
糖尿病足国际工作组（IWGDF）自1999年以来已发布并更新了国际指南。2023年的更新采用了推荐分级评估、制定和评价证据到决策框架。这涉及制定相关临床问题和重要结果，在适当情况下进行文献系统评价和荟萃分析，完成判断表总结，并撰写具体、明确且可操作的推荐意见及其透明的理由。
我们在此描述2023年IWGDF糖尿病相关足部疾病预防与管理指南的制定过程，该指南由七章组成，每章由一个国际专家独立工作组编写。这些章节提供了与糖尿病相关足部疾病预防；糖尿病相关足部溃疡的分类、减负、外周动脉疾病、感染、伤口愈合干预以及活动性夏科特神经骨关节病等方面的指南。基于这七项指南，IWGDF编辑委员会还制定了一套实用指南。每项指南都经过了IWGDF编辑委员会成员以及各领域独立国际专家的广泛审查。
我们相信，医疗保健提供者、公共卫生机构和政策制定者采用和实施2023年IWGDF指南将改善糖尿病相关足部疾病的预防和管理，进而减轻该疾病在全球范围内给患者和社会带来的负担。
