Based on the detailed review by Lazzarini et al. (2023), titled “A new declaration for feet’s sake: Halving the global diabetic foot disease burden from 2% to 1% with next generation care“, there’s a significant and pressing call to action in the field of diabetic foot disease (DFD) management and care. This comprehensive article presents a new perspective and approach towards addressing the global burden of DFD.

Key Insights from Lazzarini et al.’s Review

1. Global Burden of Diabetic Foot Disease (DFD): The review highlights that DFD is responsible for approximately 2% of the global disease burden, ranking as the 13th largest cause out of more than 350 conditions. This impact is more substantial than many well-known diseases such as dementia and breast cancer.
2. The Need for Next Generation Care: Despite advancements in diabetic foot care, the review emphasizes the necessity for next generation treatments. These include improving safe physical activity for people with neuropathy, addressing Charcot neuro-osteoarthropathy more effectively, and managing peripheral artery disease with advanced techniques.
3. Focus on Safe Physical Activity: The largest portion of the global DFD burden comes from those with neuropathy without ulcers. The review advocates for a renewed focus on increasing safe physical activity in this population, which can lead to better quality of life and reduce risks associated with DFD.
4. Charcot Neuro-osteoarthropathy (CNO): CNO is more prevalent than previously thought and often leads to severe complications. The review suggests that early surgical interventions, along with traditional non-removable offloading devices, might be more effective in managing CNO.
5. Peripheral Artery Disease (PAD): With PAD becoming more common and complex, the review points out the necessity of advanced revascularization techniques and medical management. It also highlights the potential of novel therapies like autologous cell therapy in patients with no-option critical limb ischemia.
6. Call for Global Action: The authors urge global policymakers to focus on reducing the DFD burden, suggesting that the World Health Organization and International Diabetes Federation set a new goal of halving the global DFD burden from 2% to 1% in the next generation.

Conclusion and Call to Action

The review by Lazzarini et al. is a clarion call for a concerted global effort to address the growing burden of diabetic foot disease. It underscores the need for integrated care approaches, advanced medical interventions, and a stronger focus on prevention and early treatment. The proposed goal of halving the global DFD burden is ambitious yet crucial, considering the impact of DFD on individuals’ quality of life and the healthcare system. It’s an essential step towards mitigating the effects of this often overlooked but significant complication of diabetes.

Here’s the manuscript:

A new declaration for feet’s sake: Halving the global diabetic foot disease burden from 2% to 1% with next generation care

Peter A. Lazzarini, Katherine M. Raspovic, Marco Meloni, Jaap J. van Netten