The sixth annual International Symposium on the Diabetic Foot (ISDF) recently met in the Netherlands to achieve a consensus for the next generation of worldwide guidelines for the diabetic foot. I was one of 1,000 participants from 77 nations to attend with one mission: improve the quality of care for patients with diabetes.
Before the meeting, delegates from each nation worked to ratify consensus documents on peripheral vascular disease, infection and wound healing. The American delegates included myself and Joseph Mills, MD, from the University of Arizona; Benjamin Lipsky, MD, from the University of Washington; and Lawrence Lavery, DPM, MPH, from the University of Texas Southwestern.
There were approximately a dozen invited faculty for plenary lectures and more than 200 oral and poster presentations covering an astonishing range of topics. Those topics included infection, neuropathy, offloading, diabetic footwear and wound healing.
Peter Cavanagh, PhD, DSc, presented a superb talk in which he took the costs of care for two patients, one with a simple condition and one complex, and compared costs around the world in nations including Chile, the United States, Tanzania and India. The data were really interesting. As you might imagine, the country with highest costs was the United States. However, when you factored in salary, the presence or absence of insurance (national or just private) and other data, things changed dramatically.
Attendance at the ISDF included a full range of multidisciplinary specialists including podiatrists, internists, endocrinologists, diabetologists, general surgeons, orthopedic surgeons, vascular surgeons, neurologists, rehabilitation specialists, infectious disease specialists, dermatologists, human movement scientists, general practitioners, diabetes educators, wound care specialists, orthotists, casting technicians and other healthcare providers.
The key thing, which can sound deceptively simple, is to team up with your colleagues. When you team up with someone from another discipline who cares about this problem, it is a little like pizza. Even if it is bad, it is still pretty good.
Editor’s note: Dr. Armstrong also blogs at http://www.diabeticfootonline.blogspot.com/  .