Diabetic Foot Disease during the COVID-19 Pandemic.

Andrew J M Boulton

doi:10.3390/medicina57020097

Abstract

Throughout 2020, the COVID-19 pandemic has had a major impact on the care of non-communicable diseases across the world and diabetes is no exception. Whereas many branches of medicine have adapted to telemedicine, this is difficult and challenging for the diabetic foot which often requires “hands on” treatment. This review covers the challenges that have faced clinicians across the world in the management of complex diabetic foot problems and also includes some illustrative case vignettes which show how it is possible to manage foot ulcers without the usual access to laboratory and radiological testing. There is no doubt that the COVID-19 experience when handling diabetic foot problems will likely transform our approach to the management of diabetic foot disease especially in the areas of digital health and smart technology.

Highlights

The COVID-19 PandemicIt was in late 2019 that a pneumonia of unknown cause was first reported from Wuhan, China: this was later named “coronavirus disease 2019” (COVID-19) by the World Health Organisation [1]
In this Review, several approaches to the management of diabetic foot ulcer (DFU) and more serious lower limb complications of diabetes have been reviewed from a number of different countries
The art of clinical observation has never been more important in the management of diabetic foot disease

Summary

The COVID-19 Pandemic

It was in late 2019 that a pneumonia of unknown cause was first reported from Wuhan, China: this was later named “coronavirus disease 2019” (COVID-19) by the World Health Organisation [1]. One of the early studies from Wuhan focused on the relationship between diabetes and COVID-19 and reported that the risk of Intensive Care Unit admission and fatality was much higher in patients with pre-existing diabetes and COVID-19 [4]. For many reasons, the COVID-19 pandemic has raised major challenges to the entire diabetes community [5,7]. It is vital throughout this pandemic that the most vulnerable populations, including those with diabetes and obesity, will require support and the necessary resources to restrict a day-to-day exposure to infection [7]

Diabetic Foot Disease

Diabetic Foot Disease during the COVID-19 Pandemic

Diabetic Foot Problems during the COVID-19 Pandemic

Findings

Conclusions and the Future