Diabetic foot disease is a serious problem for too many people around the world with diabetes. Not only are lower-extremity amputations among the most feared and cost-intensive complications of diabetes, but foot ulcers and amputations also considerably affect the quality of life of the individuals involved. Recent reports have stressed the importance of early recognition of the highrisk foot and the standardized provision of preventive measures to avoid foot lesions and reduce morbidity and costs resulting from those complications. Education of patients and their relatives may also help to reduce foot ulceration and amputations, especially in high-risk patients. In the case of established ulceration, diabetic foot treatment includes management of infection, aggressive angioplasty or distal revascularization, application of offloading principles, surgical débridement and stageadapted local wound care. There is increasing evidence that treatment of active diabetic foot problems carried out by multidisciplinary foot care teams is capable to reduce amputations. Shared care in a specialist network might be the way to reduce negative outcomes and high treatment costs. Availability of such services for all diabetic patients at risk should be a major future goal.

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2006
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