Greetings from Shanghai, where the 14th CODHy China Congress just wrapped up at the Shangri-La Qiantan — and where, this final afternoon, something quietly historic happened.
For the first time in the history of CODHy China, the program included a dedicated session on the Diabetic Foot and Limb Preservation. Hall B. Saturday afternoon. Standing room. A genuinely international roster of speakers and chairs. And, for me, one of those rare moments in an academic life where you look down the table and realize that the mentor who shaped you and the mentee you are trying to shape are sitting on either side of you, co-chairing the same session.
The First-Ever Limb Preservation Session at CODHy China
CODHy — the Controversies to Consensus in Diabetes, Obesity and Hypertension congress — has, since its founding by my friend Prof. Itamar Raz, made its name by taking the hardest unresolved questions in cardiometabolic medicine and forcing them into a single room. The China meeting has grown into one of the most important regional convenings in our field. And yet, until this year, the foot — and the limb — were not on the formal program.
That changed this week. The congress chairs, working with Prof. Sir Andrew Boulton and with the CODHy Secretariat, built a full Diabetic Foot and Limb Preservation session into the final afternoon of the meeting. Topics ranged from the medical management of diabetes in people with active foot disease, to vascular reconstruction in chronic limb-threatening ischemia (CLTI), to surgical offloading, to the team-based architecture that makes any of this possible. It is, in every sense that matters, a first — and a long-overdue one.
In addition to an opening lecture on wound biology I had the privilege of delivering a 20-minute lecture titled “Podiatric Surgery and Limb Salvage: Your WIfI Settings” — a working tour through the Society for Vascular Surgery’s Wound, Ischemia, and foot Infection classification, and how it can be used not as a research artifact but as a shared operational language between the toe, the flow, and the go disciplines on a Tuesday morning in clinic.
Standing Between Generations
What made this session unforgettable for me, frankly, had less to do with the science on the screen and more to do with who was sitting next to me at the chair’s table.
On one side: Prof. Andrew Boulton, of the University of Manchester — co-founder of the Malvern Diabetic Foot Meeting (which just celebrated its 40th anniversary this month, with Andrew chairing for the final time), past president of the EASD and the IDF, mentor to an entire generation of clinicians who care about the diabetic foot, and — for me personally — the person whose voice I still hear in my head every time I am about to say something stupid in a manuscript. Anyone who has read this blog for any length of time knows what Andrew means to me. The fact that we got to co-chair the first-ever limb preservation session at CODHy China together is something I will not forget.
On the other side: Prof. Wuquan Deng, of Chongqing University Central Hospital. Wuquan is a force. He directs the Chongqing Diabetic Foot Medical Research Centre, serves as Vice President of his hospital and Vice Dean of the Chongqing Emergency Medical Centre, holds a Senior Research Fellowship at King’s College London, founded the International Flow and Toe Research Team (iFORT), and is currently leading a Delphi-based international expert consensus on external phytotherapy for diabetic foot ulcer healing that has pulled together 21 experts from 11 countries. He is, in every meaningful sense, one of the world-class limb-preservation leaders of the next generation. And — at the risk of embarrassing him — he is also one of the mentees of whom I am most proud.
Between us, in age and in stage, sits about half a century of work on this problem. To get to co-chair a session in a country where Wuquan is the host and Andrew is the elder statesman, and to look across at both of them and realize that the lineage actually holds — that is not a feeling you get often. It is the feeling that this work is going to outlast all of us, which is the only reason any of it matters.
What This Session Says About Where the Field Is Going
The Chinese diabetic foot community has matured astonishingly quickly. The questions from the floor were not introductory. They were about WIfI stage 3 and 4 decision pathways, about the timing of revascularization relative to wound bed preparation, about how to build a true multidisciplinary toe-and-flow clinic inside a Chinese tertiary hospital structure. These are the same questions being asked in Manchester, in Los Angeles, in Singapore, in São Paulo. The vocabulary is converging.
The team approach is genuinely portable. One of the consistent themes across this entire China trip — from Shijiazhuang earlier in the week through Shanghai today and on to Guangzhou later this week — is that the team approach to limb preservation does not require a particular healthcare system, a particular reimbursement structure, or a particular national culture. It requires the right people sitting in the same room, agreeing on a shared classification, and committing to a shared patient. That is reproducible anywhere.
CODHy now has a foot. Having a dedicated diabetic foot and limb preservation session inside a major cardiometabolic congress is exactly the architecture our patients need. People living with diabetes do not get to neatly separate their cardiovascular care, their metabolic care, and their foot care into different rooms — and neither should we. My deepest thanks to Itamar Raz, Ronen Rahamim, and Zinnia Zhu and the CODHy Secretariat for making space for this. I hope it becomes a permanent fixture.
Thanks
To Andrew, for showing up — again, after 40 years of showing up — and for setting the tone of the session with characteristic grace and wit. To Wuquan, for the hospitality and for the high standard he holds his hospital, his city, and his country to. To the Chinese co-chairs and speakers who made the session sing. To Prof. Zhangrong Xu, Yurui Lai, and the CR Double-Crane Pharmaceutical team for the broader scaffolding of this trip. And to my much better half Tania, who somehow makes a 13-day, five-city China program feel like a vacation.
Onward to Xi’an for a couple of cultural days, and then to Guangzhou and the SUNYIXIAN Forum at Sun Yat-sen.
This is what putting weird ideas together with wonderful people looks like — across decades, across oceans, across generations.
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