Abstract
Aims
Diabetic foot syndrome (DFS) and its complications are a growing public health concern. The Italian Society of Diabetology (SID) and the Italian Association of Clinical Diabetologists (AMD), in collaboration with other scientific societies, will develop the first Italian guidelines for the treatment of DFS.
Methods
The creation of SID/AMD Guidelines is based on an extended work made by 19 panelists and 12 members of the Evidence Review Team. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology has been used to decide aims, reference population, and target health professionals. Clinical questions have been created using PICO (Patient, Intervention, Comparison, Outcome) conceptual framework. The definition of questions has been performed using a two-step web-based Delphi methodology, a structured technique aimed at obtaining by repeated rounds of questionnaires a consensus opinion from a panel of experts in areas wherein evidence is scarce or conflicting, and opinion is important.
Results
The mean age of panelists (26.3% women) was 53.7 ± 10.6 years. The panel proposed 34 questions. A consensus was immediately reached for all the proposed questions, 32 were approved and 2 were rejected.
Conclusions
The areas covered by clinical questions included diagnosis of ischemia and infection, treatment of ischemic, neuropathic, and infected ulcers, prevention of foot ulceration, organization and education issues, and surgical management. The PICO presented in this paper are designed to provide indications for healthcare professionals in charge of diabetic foot treatment and prevention, primarily based on clinical needs of people with diabetic foot syndrome and considering the existing organization of health care.
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Change history
02 April 2024
A Correction to this paper has been published: https://doi.org/10.1007/s00592-024-02263-8
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Acknowledgements
The Panel of the Italian Guidelines for the treatment of diabetic foot syndrome is composed by: Matteo Monami, Alessia Scatena, Cesare Miranda, Luca Monge, Alessandro De Cassai, Antonio Volpe, Rodolfo Tramonta, Gerardo Medea, Corrado Bordieri, Marco Falcone, Laura Stefanon, Alessandro De Cassai, Cristina Cappella; Mauro Gargiulo; Valentina Lorenzoni; Germano Scevola; Eugenio Stabile; Luigi Uccioli, Cristiana Vermigli, Andrea Bernetti.
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MM, AS, CM, LU, LM, and CV were involved in design, data collection, analysis, and writing manuscript. ADC, AV, RT, GM, CB, MF, LS, AB, CC, MG, VL, GS, and ES revised the manuscript. BR, GAS, MM, LG, CG, FR, GM, EB, FG, RDR, MA, and MM revised the manuscript and collected the data.
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MM has received speaking fees from Cook, Biocomposites, and Zuccato. All the other authors did not report any potential COI.
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Monami, M., Scatena, A., Miranda, C. et al. Development of the Italian clinical practice guidelines for the treatment of diabetic foot syndrome: design and methodological aspects. Acta Diabetol 60, 1449–1469 (2023). https://doi.org/10.1007/s00592-023-02150-8
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DOI: https://doi.org/10.1007/s00592-023-02150-8