Bullous Disease of Diabetes Guidelines

Updated: Oct 05, 2017
  • Author: Maureen B Poh-Fitzpatrick, MD; Chief Editor: Dirk M Elston, MD  more...
  • Print
Guidelines

Guidelines Summary

The American Diabetes Association guidelines for management of diabetes include these general recommendations for foot care [20] :

  • Feet inspected at every visit and comprehensive foot evaluation at least annually to identify risk factors for ulcers and amputations.
  • Foot examination should include inspection of the skin, assessment of foot deformities, neurologic assessment, and vascular assessment including pulses in the legs and feet.
  • Wounds without evidence of soft-tissue or bone infection do not require antibiotic therapy.
  • Empiric antibiotic therapy can be narrowly targeted at gram-positive cocci in acute infections.
  • Chronic, previously treated, or severe infections require broad-spectrum regimens and should be referred to specialized care centers.
  • A multidisciplinary approach is required for managment of foot ulcers and high-risk feet (eg, dialysis patients and those with Charcot foot, prior ulcers, or amputation).
  • Foot ulcers and wound care may require care by a podiatrist, orthopedic or vascular surgeon, or rehabilitation specialist experienced in the management of individuals with diabetes.