Hinchliffe RJ, Forsythe RO, Apelqvist J, Boyko EJ, Fitridge R, Hong JP, Katsanos K, Mills JL, Nikol S, Reekers J, Venermo M, Zierler RE, Schaper NC, International Working Group on the Diabetic Foot (IWGDF)., et al.
Diabetes/metabolism research and reviews. Date of publication 2020 Mar 1;volume 36 Suppl 1():e3276.
1. Diabetes Metab Res Rev. 2020 Mar;36 Suppl 1:e3276. doi: 10.1002/dmrr.3276. Epub
2020 Jan 20.
Guidelines on diagnosis, prognosis, and management of peripheral artery disease
in patients with foot ulcers and diabetes (IWGDF 2019 update).
Hinchliffe RJ(1), Forsythe RO(2), Apelqvist J(3), Boyko EJ(4), Fitridge R(5),
Hong JP(6), Katsanos K(7), Mills JL(8), Nikol S(9), Reekers J(10), Venermo M(11),
Zierler RE(12), Schaper NC(13); International Working Group on the Diabetic Foot
(IWGDF).
Author information:
(1)Bristol Centre for Surgical Research, University of Bristol, Bristol, UK.
(2)British Heart Foundation/Centre for Cardiovascular Science, University of
Edinburgh, Edinburgh, UK.
(3)Department of Endocrinology, University Hospital of Malmö, Malmö, Sweden.
(4)Seattle Epidemiologic Research and Information Centre, Department of Veterans
Affairs Puget Sound Health Care System and the University of Washington, Seattle,
WA.
(5)Vascular Surgery, The University of Adelaide, Adelaide, South Australia,
Australia.
(6)Asan Medical Center University of Ulsan, Seoul, South Korea.
(7)School of Medicine, Patras University Hospital, Patras, Greece.
(8)SALSA (Southern Arizona Limb Salvage Alliance), University of Arizona Health
Sciences Center, Tucson, AZ.
(9)Department of Interventional Angiology, Asklepios Klinik St. Georg, Hamburg,
Germany.
(10)Department of Vascular Radiology, Amsterdam Medical Centre, Amsterdam, The
Netherlands.
(11)Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
(12)Department of Surgery, University of Washington, Seattle, WA.
(13)Division of Endocrinology, MUMC+, CARIM and CAPHRI Institute, Maastricht, The
Netherlands.
The International Working Group on the Diabetic Foot (IWGDF) has published
evidence-based guidelines on the prevention and management of diabetic foot
disease since 1999. This guideline is on the diagnosis, prognosis, and management
of peripheral artery disease (PAD) in patients with foot ulcers and diabetes and
updates the previous IWGDF Guideline. Up to 50% of patients with diabetes and
foot ulceration have concurrent PAD, which confers a significantly elevated risk
of adverse limb events and cardiovascular disease. We know that the diagnosis,
prognosis, and treatment of these patients are markedly different to patients
with diabetes who do not have PAD and yet there are few good quality studies
addressing this important subset of patients. We followed the Grading of
Recommendations Assessment, Development, and Evaluation (GRADE) methodology to
devise clinical questions and critically important outcomes in the
patient-intervention-comparison-outcome (PICO) format, to conduct a systematic
review of the medical-scientific literature, and to write recommendations and
their rationale. The recommendations are based on the quality of evidence found
in the systematic review, expert opinion where evidence was not available, and a
weighing of the benefits and harms, patient preferences, feasibility and
applicability, and costs related to the intervention. We here present the updated
2019 guidelines on diagnosis, prognosis, and management of PAD in patients with a
foot ulcer and diabetes, and we suggest some key future topics of particular
research interest.
© 2020 John Wiley & Sons Ltd.
DOI: 10.1002/dmrr.3276
PMID: 31958217
