[Care of patients with the diabetic foot syndrome based on an international consensus].

In the last year an International Consensus on the Diabetic Foot has been developed by a group of independent experts from all over the world. The definition of the diabetic foot is based on WHO criteria as infection, ulceration and/or destruction of deep tissues associated with neurological abnormalities and various degrees of peripheral vascular disease in the lower limb. It is one of the most serious complications of diabetes: approximately 50% of all non-traumatic amputations are performed on patients with diabetes, it is a frequent cause of hospitalisation and disability of diabetic patients. Comprehensive prevention and therapy of diabetic foot provided by a podiatric team may reduce the number of amputations by 50% and it may decrease substantially the cost of long-lasting therapy. In all countries foot-care management should be organised at the general practitioner and podiatric nurse level and specialised foot centres with a diabetologist, a podiatric nurse, a radiologist, general, orthopaedic and vascular surgeons, an orthopaedic technician and a physiotherapist should be formed. The podiatric team has the following responsibilities--to identify patients at high risk and monitor them and to treat patients with ulcers. Treatment of diabetic foot must include non-weight bearing, long-lasting antibiotic therapy, improving circulation and topical treatment-debridement.