Preventing diabetic foot ulcers.

Approximately 6% of the U.S. diabetic population (14 million) experiences lower extremity amputation due to diabetic foot ulcers. Investigators have demonstrated that the amputation rate can be reduced through specific preventive measures. However, these findings are not consistent across studies. Integration of research findings into the model of care for the chronically ill suggests that the inconsistency may be due to the lack of inclusion of key individual and environmental variables. In this critical review of the literature, a model of care for the chronically ill is provided to direct prevention, diagnosis, and treatment of diabetic foot ulcers.