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New NICE guideline on diabetic foot problems

It is recognised that 10% of people with diabetes will have a diabetic foot ulcer at some point in their lives, with attendant high morbidity and mortality. The new NICE guidance has key priorities for implementation, including acute hospital admissions, standardising care and stratifying hazard of limb amputations across a variety of NHS settings. It updates and replaces CG119 and CG15.

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by Colin Kenny, GP, Dromore

This new guidance (NG19) acknowledges the evidence base for a multidisciplinary foot care service, suggesting that it should be standardised and commissioned, as well as outlining key professional members of the team. The guidance also stresses the importance of the first 24 hours in a hospital setting when someone is admitted with a diabetic foot problem, highlighting key actions.

NG19 also emphasises that foot assessment should start early in the young person with diabetes, outlines a standardised foot examination, and suggests that risk should be assessed and scored at low, moderate, high or active diabetic foot problem. When and how rapidly to refer is set out, as is the frequency at which foot issues should be reviewed according to a risk assessment. Finally, key evidence-based interventions are reviewed.

To access the full guideline, click here

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