Abstract
Background Diabetes is a major risk factor for foot ulceration and leg
amputation, but the effect of intensive glycaemic control on wound healing is
unknown. While an interdisciplinary approach has been shown to be important in
the management of diabetic foot ulcer (DFU), there is no standardised definition
of such an interdisciplinary team.
Objective To investigate the role of an opportunistic, rapid-access,
inter-disciplinary model of diabetes care at a foot wound clinic.
Methods A retrospective case-control study of patients with DFUs
attending a diabetes foot wound clinic over a 6-month period. Outcomes in
patients who were seen by a rapid-access interdisciplinary team (RAIT)
consisting of an endocrinologist, diabetes educator and dietician during the
standard wound care those who were not seen by this team were compared.
Results Fifty-five patients were seen by the RAIT and 64 control patients
were not seen by this team during their attendance of a diabetes foot wound
clinic. Patients in the intervention group had non-significantly higher baseline
HbA1c and a significantly larger proportion were active cigarette smokers. Both
groups achieved comparable reduction in the total number of DFUs per patient
(p=0.971). Patients in the intervention group had a 60.1%
reduction in wound size compared to 52.4% reduction in control group
(p=0.526).
Conclusion Our study shows that the use of a rapid-access
interdisciplinary team to assess and manage patients’ diabetes in a foot
wound clinic is feasible. Patients with higher-risk diabetes foot wounds exposed
to RAIT had comparable wound healing outcomes to lower risk patients.
Key words
diabetes autoimmunity - peripheral arterial disease cardiovascular incidences - neuropathy
