Prevention and Care of Diabetic Foot Ulcers

A special issue of Diabetology (ISSN 2673-4540).

Deadline for manuscript submissions: 20 January 2026 | Viewed by 2495

Special Issue Editors


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Guest Editor
Diabetes and Diabetic Foot Treatment Center, Gorizia and Monfalcone Hospital (ASUGI), Monfalcone, Italy
Interests: diabetes; diabetic foot ulcers; wound healing; osteomyelitis; ulcer prevention

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Guest Editor
ASFO Pordenone Hospital, Clinical Endocrinology and Metabolic Diseases Department, Pordenone, Italy
Interests: type 2 diabetes; diabetic foot syndrome; sulfonylureas; adjuvant wound treatments; autologous cell therapy

Special Issue Information

Dear Colleagues,

Diabetic foot is a serious complication of diabetes with a high impact on healthcare systems due to the cost of care. Moreover, ulcers are the key factor that often precedes amputation. From this perspective, prevention is crucial to stopping the chain of events that leads to lesions and, ultimately, amputation.

In the care of people with diabetes, greater attention should be paid to preventing the onset of ulcers. Preventive measures can begin with primary prevention, focusing on effective diabetes management, proper assessment of the at-risk foot, and patient education. Secondary prevention is equally important; these interventions aim to prevent recurrence, which is one of the most frequent events, affecting over 50% of patients who have healed within a year. The possibilities for action in this case are multi-faceted: surgical with preventive procedures, orthotic by providing patients with the most appropriate footwear, and educational by informing patients about the risks associated with their feet.

Dr. Roberto Da Ros
Dr. Cesare Miranda
Guest Editors

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Keywords

  • diabetic foot
  • prevention
  • diabetic foot ulcer
  • wound
  • recurrence

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Published Papers (1 paper)

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16 pages, 1020 KB  
Systematic Review
Negative-Pressure Wound Therapy in Diabetic Foot Management: Synthesis of International Randomized Evidence over Two Decades
by George Theodorakopoulos and David G. Armstrong
Diabetology 2025, 6(11), 126; https://doi.org/10.3390/diabetology6110126 - 1 Nov 2025
Viewed by 1987
Abstract
Background: Diabetic foot ulcers (DFUs) carry high risks of infection, amputation, and mortality. We systematically reviewed randomized controlled trials (RCTs) of negative-pressure wound therapy (NPWT), including single-use systems, for clinically uninfected DFUs (with sensitivity analyses for mixed/infected cohorts). Methods: We searched PubMed and [...] Read more.
Background: Diabetic foot ulcers (DFUs) carry high risks of infection, amputation, and mortality. We systematically reviewed randomized controlled trials (RCTs) of negative-pressure wound therapy (NPWT), including single-use systems, for clinically uninfected DFUs (with sensitivity analyses for mixed/infected cohorts). Methods: We searched PubMed and Scopus (1 January 2004–30 June 2024). Dual reviewers performed screening and extraction; risk of bias was assessed with Cochrane Risk of Bias 2 (RoB 2) and certainty of evidence with GRADE. When ≥2 trials reported comparable outcomes, we used random-effects meta-analysis. The DiaFu cohort reported in two publications was counted once across analyses. Results: Eleven RCT publications (n = 1699; 10 unique cohorts) met criteria; eight trials (n = 1456) informed the primary endpoint. Trials largely excluded severe ischemia; findings therefore apply mainly to neuropathic or mixed-etiology DFUs with adequate perfusion. NPWT increased complete healing at 12–16 weeks (risk ratio [RR] 1.46, 95% CI 1.21–1.76; I2 = 48%) and shortened time to healing (mean difference –18 days, 95% CI −28 to −8). Effects were similar for conventional and single-use NPWT. Outcomes did not vary systematically within commonly used pressure ranges (approximately −80 to −125 mmHg). Only two RCTs reported direct cost data (exploratory). Moderate heterogeneity (Higgins’ I2 48–68%) reflected variation in ulcer severity, device type/settings, dressing-change frequency, and off-loading protocols. Conclusions: NPWT probably improves short-term healing of clinically uninfected DFUs compared with standard care and may reduce minor amputations, without increasing adverse events. Certainty is moderate for healing and low for most secondary outcomes. Benefits appear consistent across device classes and may support earlier discharge and community-based care. Evidence gaps include ischemia-dominated ulcers, long-term outcomes (recurrence and limb preservation), adherence mechanisms, and contemporary cost-effectiveness. Full article
(This article belongs to the Special Issue Prevention and Care of Diabetic Foot Ulcers)
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