Part 6: Detection and Prevention of Foot Problems in Type 2 Diabetes

A prospective non randomised controlled study from Lithuania has assessed a multidisciplinaryapproach to diabetic footcare on recurrent ulceration and amputation(Dargis et al, 1999). 145 people with diabetes and a past history of neuropathic footulcers but no evidence of PVD were studied. All received baseline assessment andfootcare education. People in the intervention group (n=56) were followed in a specialclinic by a multi-disciplinary team of physicians, nurses and podiatrists and receivedregular podiatry and re-education every 3 months and provision of special footwear asrequired. Scotch casting was also available to aid ulcer healing. The standardtreatment group was followed in their local clinic every 3 months for routine care.Subjects in the two groups had a similar mean age of 59 years and had a similarincidence of neuropathy. Two of the intervention group and 8 of the standardtreatment group were hospitalised with ulcers. The intervention group hadsignificantly fewer recurrent ulcers during the two years compared with the standardgroup (30.4% v 58.4% respectively; OR 0.31 [CI 0.14-0.67], p