Alsararatee Hasan H, Langley Judy Clare Scott, Thorburn Mark, Burton-Gow Helen, Whitby Samuel, Powell Sarah
Advanced Clinical Practitioner, Northampton General Hospital NHS Trust, and Senior Lecturer, Advanced Clinical Practice, Buckinghamshire New University.
Senior Advanced Clinical Practitioner in Acute Medicine and Senior Lecturer, Buckinghamshire New University.
Br J Nurs. 2025 Feb 20;34(4):S12-S23. doi: 10.12968/bjon.2024.0342.
Diabetic foot disease is a severe complication of diabetes, leading to significant morbidity and lower limb amputations. This review explores the pathophysiology of diabetic foot disease, highlighting the roles of peripheral neuropathy, peripheral arterial disease and immunosuppression in the development of foot ulcers and infections. Key intrinsic and extrinsic risk factors, including long-standing diabetes, poor glycaemic control, inappropriate footwear and trauma are discussed. The importance of comprehensive diabetic foot assessments using diagnostic tools such as the Ipswich Touch Test and Doppler studies is emphasised for early detection and management. Challenges such as delays in referral to specialist care, limited access to multidisciplinary foot teams, and staffing shortages are identified as critical barriers to effective care. The review builds upon extant literature by integrating the most recent evidence, including the 2023 guidelines from the International Working Group on the Diabetic Foot. It emphasises practical application, detailed referral pathways and multidisciplinary care strategies, offering updated tools and insights to improve clinical outcomes and address the often overlooked aspects within inpatient services. Future directions encompass advances in imaging, telemedicine and patient education, which may further optimise preventive and therapeutic strategies for diabetic foot disease.
糖尿病足病是糖尿病的一种严重并发症，可导致严重发病和下肢截肢。本综述探讨了糖尿病足病的病理生理学，强调了周围神经病变、外周动脉疾病和免疫抑制在足部溃疡和感染发生中的作用。讨论了关键的内在和外在风险因素，包括长期糖尿病、血糖控制不佳、鞋具不合适和创伤。强调了使用伊普斯威奇触觉试验和多普勒研究等诊断工具进行全面糖尿病足评估对于早期检测和管理的重要性。诸如转诊至专科护理延迟、获得多学科足部团队的机会有限以及人员短缺等挑战被确定为有效护理的关键障碍。本综述通过整合最新证据，包括糖尿病足国际工作组2023年指南，在现有文献的基础上进行了拓展。它强调实际应用、详细的转诊途径和多学科护理策略，提供更新的工具和见解，以改善临床结果并解决住院服务中经常被忽视的方面。未来方向包括成像、远程医疗和患者教育方面的进展，这可能会进一步优化糖尿病足病的预防和治疗策略。
