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The Jiménez Díaz Foundation creates a Diabetic Foot Unit to speed up the diagnosis of foot ulcers in diabetics

The Mellitus diabetes, responsible for the diabetic foot, is the most common cause of leg amputation in the western world. For this reason, and with the aim of speeding up the diagnosis and treatment of foot ulcers in patients with diabetes, the Jiménez Díaz Foundation has created a Diabetic Foot Unit, integrated into its Vascular Surgery Service and specialized above all in diagnosis. early arterial disease requiring early revascularization.

“In the unit we follow an approach to the diabetic foot based on the” toe and flow “, which involves a podiatrist and a vascular surgeon and allows an early assessment and treatment of any diabetic foot ulcer”, says the Drag. Ana Begoña Arribas Díaz, associate doctor of the Angiology and Vascular Surgery Service of the Madrid hospital, who also highlights the importance of carrying out a multidisciplinary approach in the treatment of diabetic foot: “Although revascularization is a vital pillar in patients with ulcers ischemic or neuroischemic, we must not forget glycemic control, nutrition, treatment of infection, cures, discharge, orthopedic treatment or, for example, skin grafts. In the case of ulcers with serious infection, early attention in the Emergency Department is vital, so professionals from all these specialties must be involved ”.

In the approach to the diabetic foot, prevention and improvement of patient education in self-care is also essential. “In addition, it would be convenient to achieve greater podiatric care and improve the care circuit for rapid diagnosis and treatment once the ulcer appears,” says the specialist.

Diabetic foot: prevalence and patient profile

The prevalence of diabetic foot syndrome -presence of ulcers, infection or necrosis in the foot of a patient with nerve and / or vascular involvement due to Mellitus diabetes– varies between 1.3 and 4.8 percent in the world.

“About 15 percent of diabetic patients will have ulcers in the lower extremities in the course of this disease, and the risk of suffering an amputation is 8 to 15 times higher in people with diabetes than in those without the disease” , explain it Dr. Arribas, adding that “once an amputation has been suffered, the incidence of a new ulcer or amputation in the remaining limb is 50 percent at 2-5 years.”

The typical diabetic foot ulcer, generated by loss of sensitivity, is neuropathic, which occurs in long-standing diabetics and / or with poor disease control. However, at present ulcers with a greater ischemic component (caused by lack of irrigation) are found in older patients and comorbidity with other conditions, such as arterial hypertension, dyslipidemia or smoking.

Currently, the Jiménez Díaz Foundation is reorganizing care in this area with the aim of increasing the number of patients who can benefit from prevention and treatment protocols through improved communication between the different levels of care, to achieve thus greater coordination. In this context, information is a key element to analyze the results and carry out studies, which is why we are also working on a common form that allows obtaining and sharing data.

Likewise, as the Dr. Óscar Gómez, Director of Care Continuity of the hospital, “the medical and Nursing professionals of the health centers in the reference area of ​​the Jiménez Díaz Foundation have a specific diabetic foot e-consultation to make teleconsultations about their patients with this pathology, being able to send photos of the injuries, with a response from the specialists of the Diabetic Foot Unit in less than 72 hours ”.

Likewise, the hospital has launched Starts, a training project for healthcare professionals in which, through an e-learning platform, users can access interesting and up-to-date syllabi, videos and training talks on this healthcare field.

Presented recently during the webinar “Management of the diabetic foot and presentation of the Diabetic Foot Unit of the Jiménez Díaz Foundation”, aimed at professionals in Primary Care, Nursing, students and residents, it is an initiative led by the International Work Group Diabetic Foot (IWGDF) and which has the scientific sponsorship of the Spanish Diabetes Society and the Spanish Society of Angiology and Vascular Surgery.

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