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Physician experts in diabetes are natural team leaders for managing diabetic patients with foot complications. A position statement from the Italian diabetic foot study group
- Source :
- Nutrition, Metabolism and Cardiovascular Diseases. 30:167-178
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Diabetic foot syndrome (DFS) is a complex disease. The best outcomes are reported with the multi-disciplinary team (MDT) approach, where each member works collaboratively according to his/her expertise. However, which health provider should act as the team leader (TL) has not been determined. The TL should be familiar with the management of diabetes, related complications and comorbidities. He/she should be able to diagnose and manage foot infections, including prompt surgical treatment of local lesions, such as abscesses or phlegmons, in an emergent way in the first meeting with the patient. According to the Organization for Economic Co-operation and Development (OECD) reports, Italy is one of countries with a low amputation rate in diabetic patients. Many factors might have contributed to this result, including 1)the special attention directed to diabetes by the public health system, which has defined diabetes as a "protected disease", and accordingly, offers diabetic patients, at no charge, the best specialist care, including specific devices, and 2)the presence of a network of diabetic foot (DF) clinics managed by diabetologists with medical and surgical expertise. The health care providers all share a "patient centred model" of care, for which they use their internal medicine background and skills in podiatric surgery to manage acute or chronic needs in a timely manner. Therefore, according to Italian experiences, which are fully reported in this document, we believe that only a skilled diabetologist/endocrinologist should act as a TL. Courses and university master's degree programmes focused on DF should guarantee specific training for physicians to become a TL.
- Subjects :
- Health Knowledge, Attitudes, Practice
medicine.medical_specialty
Consensus
Attitude of Health Personnel
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
Clinical Decision-Making
Medicine (miscellaneous)
030209 endocrinology & metabolism
Disease
030204 cardiovascular system & hematology
Settore MED/13 - Endocrinologia
03 medical and health sciences
0302 clinical medicine
Diabetes mellitus
Diabetes
Diabetic foot
Multidisciplinary team
Team leader
Health care
medicine
Humans
Physician's Role
Patient Care Team
Nutrition and Dietetics
business.industry
Public health
medicine.disease
Leadership
Endocrinologists
Italy
Amputation
Education, Medical, Graduate
Clinical Competence
Medical emergency
Cardiology and Cardiovascular Medicine
business
Foot (unit)
Subjects
Details
- ISSN :
- 09394753
- Volume :
- 30
- Database :
- OpenAIRE
- Journal :
- Nutrition, Metabolism and Cardiovascular Diseases
- Accession number :
- edsair.doi.dedup.....cc74fdaf6c74e0361b2d5f257c6b5fad
- Full Text :
- https://doi.org/10.1016/j.numecd.2019.11.009