Guidelines on diagnosis, prognosis, and management of peripheral artery disease in patients with foot ulcers and diabetes (IWGDF 2019 update)

Robert J Hinchliffe*, Rachael O Forsythe, et al.

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

The International Working Group on the Diabetic Foot (IWGDF) has published evidence-based guidelines on the prevention and management of diabetic foot disease since 1999. This guideline is on the diagnosis, prognosis and management of peripheral artery disease in patients with foot ulcers and diabetes and updates the previous IWGDF guideline. Up to 50% of patients with diabetes and foot ulceration have concurrent peripheral artery disease (PAD), which confers a significantly elevated risk of adverse limb events and cardiovascular disease. We know that the diagnosis, prognosis and treatment of these patients are markedly different to patients with diabetes who do not have PAD and yet there are few good quality studies addressing this important sub-set of patients. We followed the GRADE methodology to devise clinical questions and critically important outcomes in the PICO format, to conduct a systematic review of the medical-scientific literature, and to write recommendations and their rationale. The recommendations are based on the quality of evidence found in the systematic review, expert opinion where evidence was not available, and a weighing of the benefits and harms, patient preferences, feasibility and applicability, and costs related to the intervention. We here present the updated 2019 guidelines on diagnosis, prognosis and management of PAD in patients with a foot ulcer and diabetes, and we suggest some key future topics of particular research interest.
Original languageEnglish
Article numbere3276
Number of pages12
JournalDiabetes/Metabolism Research and Reviews
Volume36
Issue numberS1
Early online date20 Jan 2020
DOIs
Publication statusPublished - 1 Mar 2020

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