Help Patients With Diabetes Take Care of Their Feet

You’ll see more focus on preventing and treating foot infections in patients with the prevalence of diabetes rises.

Foot infections are common in patients with diabetes...due to poor blood circulation and nerve damage in the legs and feet.

And these infections can be serious enough that they require hospitalization...or lead to amputation of the legs, feet, or toes.

The scary part is that many patients don’t realize there may be a problem until it’s too late.

Preventing foot infections is a key to avoiding amputations.

To keep feet healthy, patients should check their feet daily for cuts, sores, blisters, etc...or ask a caregiver for help.

Expect your pharmacist to also advise getting a comprehensive foot exam at least yearly...and wearing appropriate footwear.

For instance, patients should avoid going barefoot...and wear shoes that are comfortable, cover the foot, and fit well. Explain that Medicare Part B may cover therapeutic shoes and inserts, if needed.

Stay alert for diabetes meds and testing supplies that aren’t picked up...and reach out to patients to find out why. Keeping blood sugar under control can prevent nerve damage...circulation problems...and lower the chance of foot infection.

Treating foot infections with antibiotics as soon as possible can reduce the risk of complications, such as amputation.

Anticipate dispensing a 7-to-14-day course of oral antibiotics (cephalexin, dicloxacillin, etc) for most patients with a mild diabetes-related foot infection.

But expect that IV meds will be needed in more severe cases.

For example, patients with an infection that has reached the bone...or whose oral meds aren’t working...will usually get antibiotics such as ampicillin/sulbactam or ceftriaxone plus metronidazole.

Keep in mind that appropriate wound care can also help with healing. Be ready to order dressings or other supplies to protect the wound...or refer patients to a medical supply store, if needed.

See our resource, Skin and Soft Tissue Infections, for more about foot infections in patients with diabetes...including risk factors, antibiotic choices, and wound management.

Key References

  • Senneville É, Albalawi Z, van Asten SA, et al. IWGDF/IDSA Guidelines on the Diagnosis and Treatment of Diabetes-related Foot Infections (IWGDF/IDSA 2023). Clin Infect Dis. 2023 Oct 2:ciad527. doi: 10.1093/cid/ciad527.
  • Peters EJG, Albalawi Z, van Asten SA, et al. Interventions in the management of diabetes-related foot infections: A systematic review. Diabetes Metab Res Rev. 2023 Oct 10:e3730. doi: 10.1002/dmrr.3730.
  • Polk C, Sampson MM, Roshdy D, Davidson LE. Skin and Soft Tissue Infections in Patients with Diabetes Mellitus. Infect Dis Clin North Am. 2021 Mar;35(1):183-197.
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