Department of Podiatry, Faculty of Health Sciences, University of Johannesburg, South Africa.
Foot (Edinb). 2024 Sep;60:102126. doi: 10.1016/j.foot.2024.102126. Epub 2024 Aug 22.
Diabetic foot complications are serious issues resulting from uncontrolled diabetes, primarily affecting the feet. Common complications include diabetic neuropathy, ulcers, PAD, Charcot foot, and gangrene. Preventive measures include controlling blood glucose levels, regular foot inspections, proper foot care, wearing appropriate footwear, and seeking prompt medical attention. A holistic approach to diabetic foot management is crucial due to the complex interplay of physiological, psychological, and environmental factors. Glycaemic control is essential for mitigating neuropathy and vasculopathy, while cardiovascular risk factors like hypertension and dyslipidemia are crucial for preventing complications. In South Africa, podiatrists play a crucial role in diabetic foot care, offering specialized expertise in the assessment, management, and prevention of foot complications associated with diabetes mellitus. They collaborate closely with other healthcare professionals to ensure comprehensive and coordinated care.Pharmacological management is a crucial aspect of podiatric care in the UK, where podiatrists use various medications to treat foot conditions effectively. In South Africa, podiatrists lack prescribing authority, leading to limited treatment options, dependency on referrals, and disparities in access to care. This fragmented approach can compromise patient outcomes, especially in chronic conditions like diabetes. To improve patient outcomes and promote optimal foot condition management, policy reforms, interdisciplinary collaboration, and professional advocacy efforts are needed.Policy recommendations for expanding podiatrist prescribing privileges include legislative reforms, regulatory framework updates, and professional accreditation. Legislative reforms could involve amending existing healthcare laws or introducing new regulations that recognize podiatrists as authorized prescribers. Regulatory framework updates should involve working with regulatory bodies to establish prescribing standards, prescribing limitations, and mechanisms for ongoing oversight and accountability. Professional accreditation should ensure educational programs for podiatrists incorporate training in pharmacology, pharmacotherapy, and prescribing practices to prepare graduates for the expanded scope of practice.Stakeholders in South Africa can improve diabetes management by advocating for policy reforms, professional recognition, and patient empowerment initiatives. By aligning policy, practice, education, research, and advocacy efforts, stakeholders can create a supportive ecosystem that fosters innovation, collaboration, and continuous improvement in diabetic foot care.
糖尿病足并发症是由未控制的糖尿病引起的严重问题，主要影响足部。常见的并发症包括糖尿病神经病变、溃疡、PAD、Charcot 足和坏疽。预防措施包括控制血糖水平、定期检查足部、正确护理足部、穿着合适的鞋子和及时就医。由于生理、心理和环境因素的复杂相互作用，对糖尿病足进行整体管理至关重要。血糖控制对于减轻神经病变和血管病变至关重要，而高血压和血脂异常等心血管危险因素对于预防并发症也至关重要。在南非，足病医生在糖尿病足护理中发挥着至关重要的作用，他们提供专业的评估、管理和预防糖尿病相关足部并发症的专业知识。他们与其他医疗保健专业人员密切合作，确保全面协调的护理。在英国，药物治疗是足病护理的一个重要方面，足病医生使用各种药物来有效治疗足部疾病。在南非，足病医生没有处方权，导致治疗选择有限，依赖转诊，以及获得护理的机会不平等。这种分散的方法可能会影响患者的治疗效果，特别是在糖尿病等慢性疾病的情况下。为了改善患者的治疗效果并促进最佳足部状况的管理，需要进行政策改革、跨学科合作和专业倡导。扩大足病医生处方权的政策建议包括立法改革、监管框架更新和专业认证。立法改革可以包括修改现有的医疗保健法律或引入新的法规，承认足病医生为授权处方者。监管框架更新应涉及与监管机构合作，制定处方标准、处方限制以及持续监督和问责机制。专业认证应确保足病医生的教育计划包括药理学、药物治疗学和处方实践的培训，为扩大实践范围做好准备。南非的利益相关者可以通过倡导政策改革、专业认可和患者赋权倡议来改善糖尿病管理。通过协调政策、实践、教育、研究和倡导工作，利益相关者可以创建一个支持性的生态系统，促进糖尿病足护理的创新、合作和持续改进。
