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Managing the diabetic foot

Most amputations in people with diabetes are preceded by a foot ulcer — and most of those ulcers are preventable.

Assessment

  • Annual check of circulation, sensation and foot shape for everyone with diabetes
  • Urgent same-week assessment for any new ulcer, redness or swelling
  • Ankle and toe pressures and duplex ultrasound to measure blood flow
  • Imaging and sampling where bone infection is suspected

Treatment principles

Care follows international guidance: relieve pressure on the wound, control infection promptly, restore arterial blood flow where it is inadequate, debride dead tissue, and manage blood sugar in parallel. Decisions are made by a team including vascular surgery, podiatry, diabetes medicine and microbiology.

Where blood flow is the limiting factor, angioplasty or bypass comes first — dressings alone will not heal an ischaemic foot.

Associations & Hospitals

Professional associations and hospitals Professor Sultan works with

Logos of the Western Vascular Institute, Galway Clinic, European Society for Vascular Surgery, International Society of Endovascular Specialists, Vascular and Endovascular Surgery Society, Royal College of Surgeons in Ireland, Saolta University Health Care Group, Society for Vascular Surgery, Galway University Hospitals, Vascular Society, and NUI Galway