The Promise and Hurdles of Telemedicine in Diabetes Foot Care Delivery

This chapter from our combined SALSA – iCAMP team in Houston and Los Angeles.

Najafi B., Swerdlow M., Murphy G.A., Armstrong D.G. (2021) The Promise and Hurdles of Telemedicine in Diabetes Foot Care Delivery. In: Latifi R., Doarn C.R., Merrell R.C. (eds) Telemedicine, Telehealth and Telepresence. Springer, Cham.


Almost half of people with diabetes have peripheral nerve dysfunction (neuropathy; PN) or poor blood supply to the lower limb caused by diabetes or peripheral artery disease (PAD). They are at a high risk of developing foot complications, such as ulcers, gangrene, and infection. Recent efforts to reduce the burden of foot disease and its associated complications have focused on better treatment of foot complications within tertiary facilities. While this has had some impact in reducing the burden, there are a number of limitations with a treatment-focused approach. A prevention-focused approach could reduce these problems, including the common failure to avoid amputation, high recurrence rates, and repeat hospitalization episodes – a frequently occurring and expensive problem that is associated with poor quality of life and death. Delivery of preventative care also needs to address the issue of multidisciplinary management teams typically being available only at tertiary hospitals, thereby disadvantaging people not living in major metropolitan areas. The widespread uptake and acceptance of technology represents an opportunity to prevent devastating foot complications and address the current challenges in delivery of multidisciplinary care to remote areas. Telemedicine in particular could be a promising technology to facilitate the delivery of interdisciplinary care to people who have limited access in remote areas. This chapter overviews the promises and hurdles of telemedicine to manage diabetic foot complications.

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