《糖尿病患者足溃疡预防指南(IWGDF2023更新)》解读与应用

Interpretation and application of guidelines on the prevention of foot ulcers in patients with diabetes(IWGDF2023 Updated)

足溃疡预防是降低糖尿病患者截肢率的重要一环。关于糖尿病足溃疡的预防,国际糖尿病足工作组2023年指南与其2019年指南有着很大的不同,最主要的变化是对各条推荐意见补充了高级别的证据内容(大多为随机对照研究的结果);主张将局部皮温测定、参加足踝运动训练和心理干预等用于足病的预防。本文从识别高危足、定期检查高危足、健康教育、确保日常穿着合适鞋、治疗溃疡危险因素以及综合足部护理这6个方面对2版指南进行比较;并结合临床,对2023年版指南在中国的应用进行分析和展望。

Foot ulcer prevention plays a crucial role in reducing the amputation rate among diabetic patients.With regard to the prevention of diabetic foot ulcers,the 2023 guidelines of the International Working Group of Diabetic Foot(IWGDF)were different from the 2019 counterpart.The most notable change is the addition of high-level evidence to support recommendations,primarily derived from randomized controlled studies.The 2023 guidelines also advocate for local skin temperature measurement,participation in ankle exercise training,and psychological intervention for foot ulcer prevention.This article conducts a comparative analysis of the two guidelines across six key dimensions:identification of high-risk feet,regular examination of high-risk feet,health education,ensuring appropriate daily footwear,addressing ulcer risk factors,and comprehensive foot care.Drawing from clinical insights,the application and prospective implications of the 2023 guidelines in China are also examined.