Older people and footcare - resources
Here are links to evidence-based resources which support this area of practice. You may also want to refer to information about the national service frameworks and strategies across the UK.
Some of the resources listed below are in PDF format - see how to access PDF files.
Guidelines and guidance
Diabetes UK (2009) Putting feet first: commissioning specialist services for the management and prevention of diabetic foot disease in hospitals
This guidance produced by Diabetes UK in collaboration with other organisations aims to support proper management of acute onset or deteriorating, disease of the diabetic foot and prevent amputation. It complements the 'National Minimum Skills Framework for Commissioning of Foot Care Services for people with diabetes'.
Foot in diabetes UK (FDUK) et al (2006) The National Minimum Skills Framework for Commissioning of Foot Care Services for people with diabetes (PDF 879.8KBK)
A skills framework which aims to help local service providers to deliver high quality foot care services for people with diabetes.
National Diabetes Support Team (NDST) (2006) Diabetic Foot Guide (PDF 1MB)
A comprehensive guide to improving foot care for people with diabetes, which looks at screening and prevention, care pathways, multidisciplinary working and workforce and skills. The guide is made available on the NHS Diabetes website.
National Institute for Health and Clinical Excellence (2011) Diabetic foot - inpatient management of people with diabetic foot ulcers and infection
This short clinical guideline offers evidence-based advice on the inpatient care of people with diabetic foot problems from hospital admission onwards.
Systematic reviews and evidence summaries
For more information about Cochrane Systematic Reviews, examples of which appear below, visit the page within this resource on the Cochrane Library.
BMC Health Services Research (2009) Systematic review of economic evaluations of human cell-derived wound care products for the treatment of venous leg and diabetic foot ulcers
Based on a systematic review of the literature, this study assesses the cost-effectiveness of growth factors and tissue-engineered artificial skin for treating chronic wounds.
Cochrane Review: Granulocyte-colony stimulating factors (G-CSF) as adjunctive therapy for diabetic foot infections
The aim of this review is to examine the effects of adjunctive G-CSF compared with placebo or no growth factor, added to usual care on rates of infection, cure and wound healing in people with diabetes who have a foot infection.
Cochrane Review: debridement of diabetic foot ulcers
The aim of this review is to assess the evidence for the effectiveness of debridement which is widely regarded as an effective intervention to speed up ulcer healing, and to assess which is the most effective method.
Cochrane Review: patient education for preventing diabetic foot ulceration
This review aimed to assess the effectiveness of patient education on the prevention of foot ulcers one of the key health problems for people with diabetes mellitus.
Cochrane Review: pressure relieving interventions for preventing and treating diabetic foot ulcers
Foot ulceration is thought to affect 15% of all people with diabetes at some time during their life. This review assesses the effectiveness of pressure relieving interventions in the prevention and treatment of diabetic foot ulcers.
Cochrane Review: silver based wound dressings and topical agents for treating diabetic foot ulcers
Foot ulceration is a major precursor to amputation, and early and appropriate treatment provides the greatest opportunity for healing. This review evaluates the effects of silver-containing dressings and topical agents on infection rates and healing of diabetes related foot ulcers.
NHS Health Technology Assessment Programme (2006) A series of systematic reviews to inform a decision analysis for sampling and treating infected diabetic foot ulcers
Diagnosing infection is important as infection can lead to amputation. This review concentrates on the diagnosis of infection and the management of diabetic foot ulcers with antimicrobial agents.
Other resources
Diabetes UK: feet
This section of the Diabetes UK website provides information on specific care for elderly people with diabetes and their feet.
Diabetic Foot
This resource is designed to assist health care professionals who look after the foot problems of diabetic patients. It includes information on footcare, footwear, hosiery, casting, sensory testing, monofilaments and circulation tests. The website has foot care advice leaflets in 31 languages.
Diabetic Foot Study Group (DFSG)
The Diabetic Foot Study Group of the European Association for the Study of Diabetes aims to promote an advancement of knowledge on all aspects of diabetic foot care through active co-operation and collaboration between diabetologists, podiatrists, specialist nurses, orthopaedic and vascular surgeons and all other specialists with an interest in caring for diabetic patients with foot problems.
Foot in Diabetes UK
FDUK is an international, independent, multi-professional, group of people who are involved in the care, management and research of people with diabetic foot disease. The group is closely associated with Diabetes UK and has links with other diabetes organisations throughout the world.
National Library of Medicine MEDLINEplus service: diabetes foot care
An interactive tutorial requiring flash plug-in. The presentation is in three formats; a multimedia questionnaire with questions, a self-playing tutorial without questions, and a printer-friendly text version.
NHS Choices: foot care and diabetes
This section of the NHS Choices website provides information about foot care for people who have diabetes. It is aimed at the general public.
Nursing Times and National Institute for Health and Clinical Excellence (2011) Diabetic foot problems
A free online unit on diabetic foot problems which looks at: common foot problems associated with diabetes and their clinical and wider significance for the patient; why diabetic foot ulcers should be managed by a multidisciplinary specialist foot care team; and the recommended care pathway for patients with diabetic foot ulcers.
Podiatry channel: diabetes and foot problems
The podiatry channel provides comprehensive information about conditions that affect the legs and feet, including diabetes. There is also a forum which can enable discussion and sharing of experiences.
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