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The Diabetic Foot

Edited by: Mr Peter Lazzarini, Prof Hylton Menz

Diabetes results in significant morbidity and mortality, and is at epidemic levels worldwide. Foot disease (usually foot ulceration) is a leading cause of diabetes hospitalisation and amputation. Alarmingly, 1.5 million people worldwide experience a lower limb amputation (one every 20 seconds) and over 4 million suffer with foot ulcers due to diabetes each year. A significant body of existing international research demonstrates effective clinical management of diabetes foot disease can prevent up to 90% of hospitalisations and amputations.

In support of the Australasian Podiatry Council’s Foot Health Month campaign Sock it to Diabetes in October 2012, we have selected some of the best diabetic foot research papers recently published in the Journal of Foot and Ankle Research to create this special article collection. We hope that this collection will contribute to the existing international research momentum to find treatments and cures for the great global challenge of diabetes foot disease.

  1. Diabetic foot complications are the leading cause of lower extremity amputation and diabetes-related hospitalisation in Australia. Studies demonstrate significant reductions in amputations and hospitalisation ...

    Authors: Thomas R Quinton, Peter A Lazzarini, Frances M Boyle, Anthony W Russell and David G Armstrong
    Citation: Journal of Foot and Ankle Research 2015 8:16
  2. Approximately 10%–15% of people with diabetes develop at least one foot ulcer during their lifetime. Treatment of diabetic foot ulcers (DFUs) represents a significant economic burden. Enzymatic debridement wit...

    Authors: Travis A Motley, Adrienne M Gilligan, Darrell L Lange, Curtis R Waycaster and Jaime E Dickerson Jr
    Citation: Journal of Foot and Ankle Research 2015 8:7

    The Erratum to this article has been published in Journal of Foot and Ankle Research 2016 9:28

  3. Extracorporeal shock wave therapy has been reported as an effective treatment for lower limb ulceration. The aim of this systematic review was to investigate the effectiveness of extracorporeal shock wave ther...

    Authors: Paul A Butterworth, Tom P Walsh, Yvonne D Pennisi, Anna D Chesne, Christoph Schmitz and Susan A Nancarrow
    Citation: Journal of Foot and Ankle Research 2015 8:3
  4. The purpose of this study was to examine the prevalence of depressive symptoms, diabetes self-management, and quality of life in people with diabetes and foot ulcers. Ulcer status, mortality and amputations we...

    Authors: Sue Pearson, Toni Nash and Vanessa Ireland
    Citation: Journal of Foot and Ankle Research 2014 7:47
  5. Australian subacute inpatient rehabilitation facilities face significant challenges from the ageing population and the increasing burden of chronic disease. Foot disease complications are a negative consequenc...

    Authors: Brenton J Earl, Peter A Lazzarini, Ewan M Kinnear and Petrea L Cornwell
    Citation: Journal of Foot and Ankle Research 2014 7:41
  6. Australia is ranked ninth of 39 countries in the Western Pacific region most affected by diabetes. Patients with diabetes are at high risk of developing foot ulcerations that can develop into non-healing wound...

    Authors: Norafizah Haji Zaine, Joshua Burns, Mauro Vicaretti, John P Fletcher, Lindy Begg and Kerry Hitos
    Citation: Journal of Foot and Ankle Research 2014 7:39
  7. Hallux valgus deformity is a common musculoskeletal foot disorder with a prevalence of 3.5% in adolescents to 35.7% in adults aged over 65 years. Radiographic measurements of hallux valgus angles (HVA) are con...

    Authors: Daniël MC Janssen, Antal P Sanders, Nick A Guldemond, Joris Hermus, Geert HIM Walenkamp and Lodewijk W van Rhijn
    Citation: Journal of Foot and Ankle Research 2014 7:33
  8. In this article the authors explore the current issues and barriers related to achieving successful outcomes to diabetic foot complications in India. This was achieved by engaging clinicians in taking ownershi...

    Authors: Michael Harrison-Blount, Michelle Cullen, Christopher J Nester and Anita E Williams
    Citation: Journal of Foot and Ankle Research 2014 7:30
  9. Charcot foot is a rare but devastating complication of diabetes. Little research is available on the mental health impact of Charcot foot. Aim of the study is to assess mental health in diabetes patients with ...

    Authors: Zahra Chapman, Charles Matthew James Shuttleworth and Jörg Wolfgang Huber
    Citation: Journal of Foot and Ankle Research 2014 7:22
  10. Previous work has found that people with diabetes do not wear their therapeutic footwear as directed, but the thinking behind this behaviour is unclear. Adherence to therapeutic footwear advice must improve in...

    Authors: Joanne S Paton, Anne Roberts, Graham K Bruce and Jonathan Marsden
    Citation: Journal of Foot and Ankle Research 2014 7:16
  11. Foot disease complications, such as foot ulcers and infection, contribute to considerable morbidity and mortality. These complications are typically precipitated by “high-risk factors”, such as peripheral neur...

    Authors: Peter A Lazzarini, Vanessa Ng, Ewan M Kinnear, Maarten C Kamp, Suzanne S Kuys, Cameron Hurst and Lloyd F Reed
    Citation: Journal of Foot and Ankle Research 2014 7:7
  12. Foot ulceration has been reported as the leading cause of hospital admission and amputation in individuals with diabetes. Diabetes-related foot ulcers require multidisciplinary management and best practice car...

    Authors: Lucia Michailidis, Cylie M Williams, Shan M Bergin and Terry P Haines
    Citation: Journal of Foot and Ankle Research 2014 7:1
  13. To enhance the acute management of people with diabetic foot disease requiring admission, an extended scope of practice, podiatric high-risk foot coordinator position, was established at the Great Western Hosp...

    Authors: Matthew J Cichero, Virginia M Bower, Tom P Walsh and Ben J Yates
    Citation: Journal of Foot and Ankle Research 2013 6:47
  14. Higher plantar pressures play an important role in the development of plantar foot ulceration in diabetic polyneuropathy and earlier studies suggest that higher pressures under the forefoot may be related to a...

    Authors: Tom Melai, Nicolaas C Schaper, T Herman IJzerman, Ton LH de Lange, Paul JB Willems, Valéria Lima Passos, Aloysius G Lieverse, Kenneth Meijer and Hans HCM Savelberg
    Citation: Journal of Foot and Ankle Research 2013 6:41
  15. The aim of this systematic review was to evaluate the strength of the existing research to answer the question: Is an increase in skin temperature predictive of neuropathic foot ulceration in people with diabe...

    Authors: Vanessa J Houghton, Virginia M Bower and David C Chant
    Citation: Journal of Foot and Ankle Research 2013 6:31
  16. Charcot Neuro-Arthropathy (CN) is one of the more devastating complications of diabetes. To the best of the authors’ knowledge, it appears that no clinical tools based on a systematic review of existing litera...

    Authors: Tamara E Milne, Joseph R Rogers, Ewan M Kinnear, Helen V Martin, Peter A Lazzarini, Thomas R Quinton and Frances M Boyle
    Citation: Journal of Foot and Ankle Research 2013 6:30
  17. Removable plug insoles appear to be beneficial for patients with diabetic neuropathic feet to offload local plantar pressure. However, quantitative evidence of pressure reduction by means of plug removal is li...

    Authors: Tung-Liang Lin, Huey-Min Sheen, Chin-Teng Chung, Sai-Wei Yang, Shih-Yi Lin, Hong-Ji Luo, Chung-Yu Chen, I-Cheng Chan, Hsu-Sheng Shih and Wayne Huey-Herng Sheu
    Citation: Journal of Foot and Ankle Research 2013 6:29
  18. Neuropathic deformities impair foot and ankle joint mobility, often leading to abnormal stresses and impact forces. The purpose of our study was to determine differences in radiographic measures of hind foot a...

    Authors: David R Sinacore, David J Gutekunst, Mary K Hastings, Michael J Strube, Kathryn L Bohnert, Fred W Prior and Jeffrey E Johnson
    Citation: Journal of Foot and Ankle Research 2013 6:11
  19. Trauma, in the form of pressure and/or friction from footwear, is a common cause of foot ulceration in people with diabetes. These practical recommendations regarding the provision of footwear for people with ...

    Authors: Shan M Bergin, Vanessa L Nube, Jan B Alford, Bernard P Allard, Joel M Gurr, Emma L Holland, Mark W Horsley, Maarten C Kamp, Peter A Lazzarini, Ashim K Sinha, Jason T Warnock and Paul R Wraight
    Citation: Journal of Foot and Ankle Research 2013 6:6
  20. Flexor tenotomy is a minimally invasive surgical alternative for the treatment of neuropathic diabetic foot ulcers on the distal end of the toe. The influence of infection on healing and time to heal after fle...

    Authors: Jaap J van Netten, Adriaan Bril and Jeff G van Baal
    Citation: Journal of Foot and Ankle Research 2013 6:3
  21. Total contact casting is regarded as the gold standard treatment for plantar foot ulcers. Load transfer from the plantar surface of the foot to the walls of the total contact cast has previously been assessed ...

    Authors: Lindy Begg, Patrick McLaughlin, Leon Manning, Mauro Vicaretti, John Fletcher and Joshua Burns
    Citation: Journal of Foot and Ankle Research 2012 5:32
  22. Neuropathic diabetic foot ulceration may be prevented if the mechanical stress transmitted to the plantar tissues is reduced. Insole therapy is one practical method commonly used to reduce plantar loads and ul...

    Authors: Joanne S Paton, Elizabeth A Stenhouse, Graham Bruce, Daniel Zahra and Ray B Jones
    Citation: Journal of Foot and Ankle Research 2012 5:31
  23. Offloading plantar pressure is a key strategy for the prevention or healing of neuropathic plantar ulcers in diabetes. Non-removable walking casts, such as total contact casts, are currently considered the gol...

    Authors: Anita Raspovic, Karl B Landorf, Jana Gazarek and Megan Stark
    Citation: Journal of Foot and Ankle Research 2012 5:25
  24. Diabetes is one of the greatest public health challenges to face Australia. It is already Australia’s leading cause of kidney failure, blindness (in those under 60 years) and lower limb amputation, and causes ...

    Authors: Peter A Lazzarini, Joel M Gurr, Joseph R Rogers, Andrew Schox and Shan M Bergin
    Citation: Journal of Foot and Ankle Research 2012 5:24
  25. A reliable tool to measure arterial flow to the feet in people with diabetes is required given that they are particularly prone to peripheral arterial disease. Traditionally, the ankle brachial index (ABI) has...

    Authors: Christopher Scanlon, Kris Park, David Mapletoft, Lindy Begg and Joshua Burns
    Citation: Journal of Foot and Ankle Research 2012 5:13
  26. Lower extremity amputation results in significant global morbidity and mortality. Australia appears to have a paucity of studies investigating lower extremity amputation. The primary aim of this retrospective ...

    Authors: Peter A Lazzarini, Sharon R O’Rourke, Anthony W Russell, Damien Clark and Suzanne S Kuys
    Citation: Journal of Foot and Ankle Research 2012 5:12
  27. Amongst the many identified mechanisms leading to diabetic foot ulceration, ill-fitting footwear is one. There is anecdotal evidence that people with diabetic peripheral neuropathy wear shoes that are too smal...

    Authors: Alistair D McInnes, Farina Hashmi, Lisa J Farndon, Amanda Church, Maria Haley, Debora M Sanger and Wesley Vernon
    Citation: Journal of Foot and Ankle Research 2012 5:9
  28. There is limited understanding of the foot-health of people with diabetes in Australian regional areas. The aim of this study was to document the foot-health of people with diabetes who attend publically funde...

    Authors: Byron M Perrin, Marcus J Gardner and Susan R Kennett
    Citation: Journal of Foot and Ankle Research 2012 5:6
  29. Effective treatment of tinea pedis and onychomycosis is crucial for patients with diabetes as these infections may lead to foot ulcers and secondary bacterial infections resulting in eventual lower limb amputa...

    Authors: Lisa Matricciani, Kerwin Talbot and Sara Jones
    Citation: Journal of Foot and Ankle Research 2011 4:26
  30. Information describing variation in health outcomes for individuals with diabetes related foot disease, across socioeconomic strata is lacking. The aim of this study was to investigate variation in rates of ho...

    Authors: Shan M Bergin, Caroline A Brand, Peter G Colman and Don A Campbell
    Citation: Journal of Foot and Ankle Research 2011 4:17
  31. Foot ulcers are a frequent reason for diabetes-related hospitalisation. Clinical training is known to have a beneficial impact on foot ulcer outcomes. Clinical training using simulation techniques has rarely b...

    Authors: Peter A Lazzarini, Elizabeth L Mackenroth, Patricia M Régo, Frances M Boyle, Scott Jen, Ewan M Kinnear, Graham M PerryHaines and Maarten Kamp
    Citation: Journal of Foot and Ankle Research 2011 4:16