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Case studies
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Brought to you by Diabetes & Primary Care, the three mini-case studies presented below take you through the considerations of managing problems with the diabetic foot. The scenarios provide different sets of circumstances that you could meet in your everyday practice. By actively engaging with them, you will feel more confident and empowered to manage such presentations effectively in the future.

(Prepared in October 2022)


  1. NICE (2019) Diabetic foot problems: prevention and management (NG19).
  2. Baker N, Kenny C (2016) Prevention, screening and referral of the diabetic foot in primary care. Diabetes & Primary Care 18: 234–42;
  3. Sharma SKerry CAtkins HRayman G (2014) The Ipswich Touch Test: a simple and novel method to screen patients with diabetes at home for increased risk of foot ulceration. Diabet Med 31: 1100–3
  4. Diabetes UK (2022) Testing for sensitivity in your feet.
  5. NICE (2020) Neuropathic pain in adults: pharmacological management in non-specialist settings (CG173).
  6. Tesfaye S, Sloan G, Petrie J et al; on behalf of the OPTION-DM trial group (2022) Comparison of amitriptyline supplemented with pregabalin, pregabalin supplemented with amitriptyline, and duloxetine supplemented with pregabalin for the treatment of diabetic peripheral neuropathic pain (OPTION-DM): a multicentre, double-blind, randomised crossover trial. Lancet 400: 680–90;
  7. NICE (2022) Clinical Knowledge Summary: Neuropathic pain – drug treatment.
  8. Clayton W, Elasy TA (2009) Diabetic foot ulcers: pathophysiology, classification and treatment of foot ulcers in diabetic patients. Clin Diabetes 27: 52–8
  9. Diggle J (2021) How to assess feet to prevent foot ulceration in people with diabetes. Diabetes & Primary Care 23: 105–7;
  10. Phillips A, Edmonds M, Holmes P et al (2020) ACTNOW in diabetes and foot assessments: an essential service. Practice Nursing 31: 476–9;
  11. Diabetes UK (2017) Improving footcare for people with diabetes and saving money: an economic study in England.
  12. Krishnan S, Nash F, Baker N et al (2008) Reduction in diabetic amputations over 11 years in a defined U.K. population: benefits of multidisciplinary teamwork and continuous prospective audit. Diabetes Care31: 99–101
  13. NICE (2020) Peripheral arterial disease: diagnosis and management (CG147).
  14. Rogers LC, Frykburg RG, Armstrong DG et al (2011) The Charcot foot in diabetes. Diabetes Care 34: 2123–9

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