February 2020 — D-Foot EUR launched its Regional Council

The first meeting of the D-Foot European Regional Council took place in Treviso, Italy, on 24 February 2020. The newly-established Council prioritised actions points for the coming months.

The European Regional Chairs Roberto Anichini, Italy, and Norina Gavan, Romania (by Skype) chaired the meeting. The D-Foot Board members José Luis Lázaro Martínez, Spain, President of D-Foot International, and Nina Petrova, UK, Vice-President, supported the meeting. 

National representatives from different regions in Europe included Fran Game (UK), Oleg Udovichenko (Russia), Anne Rasmussen (Denmark), Ralf Lobmann (Germany), by Skype, and Tsvetalina Tankova (Bulgaria), by Skype. 

Meeting objectives

The meeting’s objectives were:

  • to assess the level of organisation of diabetic foot care in Europe; 
  • to understand the differences between countries at the national level on factors influencing the implementation of the IWGDF Guidance, and
  • to identify the current need for assistance, by analysing any discrepancy between current recommendations and everyday work practice in the various regions of Europe.

Identifying barriers for implementation

The overall aim was to underpin the real situation in Europe and identify the 3 main barriers for implementing IWGDF Guidance, which include: 

  1. Poor recognition of the impact of diabetic foot disease in Europe (with notable differences within and between  countries); variable availability of resources intended for primary and secondary prevention and care;  lack of consistency in reporting outcomes and lack of availability of electronic data records of events (i.e. amputations);
  2. Sparse awareness of prevention of foot ulcers, even among healthcare professionals (often amputation may be offered at a first instance as saving a limb may not seem “cost-effective” due to funding and organisation of  multidisciplinary clinical pathways);
  3. Regional and country-specific difficulties in establishing multidisciplinary care and integration of foot care.

Priorities for the next few months

At this meeting, 5 top priorities for Europe were identified: 

  1. To establish, audit and improve regional and national registry of diabetes as a condition as well as registration of cases with diabetic foot disease;
  2. To develop a special disease code (ICD9CM) for diabetic foot;
  3. Keep a record of existing foot units and develop programmes for implementation of knowledge/skills; 
  4. Recognise the importance of new technology and telemedicine;
  5. Register the very first diabetic foot ulcer and monitor its natural history to healing and return to daily routine and follow recommendations to avoid recurrence.

Next steps

The meeting stated the 3 most important actions to be considered in the coming months:

  1. To improve recognition of D-Foot in Europe: to expand its network and develop actions to disseminate the guidelines widely and homogeneously in all countries;
  2. National Organisation: to integrate a patient-centred network of a multi-professional and multi-disciplinary care pathway for diabetic foot; 
  3. European level:  to campaign for improved awareness of the impact of diabetic foot disease on society and national government level as well as in the European Community; to make legislative and health organisation decisions to establish assistance in directing resources towards a policy for prevention, diagnosis and treatment of diabetic foot.