{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T18:04:03Z","timestamp":1792519443393,"version":"4.5.0"},"reference-count":72,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,6,11]],"date-time":"2023-06-11T00:00:00Z","timestamp":1686441600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This is the 2023 International Working Group on the Diabetic Foot guideline on the prevention of foot ulcers in persons with diabetes, which updates the 2019 guideline. This guideline is targeted at clinicians and other healthcare professionals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We followed the Grading of Recommendations, Assessment, Development and Evaluations methodology to devise clinical questions and critically important outcomes in the PICO format, to conduct a systematic review of the medical\u2010scientific literature including, where appropriate, meta\u2010analyses, and to write recommendations and their rationale. The recommendations are based on the quality of evidence found in the systematic review, expert opinion where (sufficient) evidence was not available, and a weighing of the desirable and undesirable effects of an intervention, as well as patient preferences, costs, equity, feasibility and applicability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We recommend screening a person with diabetes at very low risk of foot ulceration annually for the loss of protective sensation and peripheral artery disease, and screening persons at higher risk at higher frequencies for additional risk factors. For preventing a foot ulcer, educate persons at\u2010risk about appropriate foot self\u2010care, educate not to walk without suitable foot protection, and treat any pre\u2010ulcerative lesion on the foot. Educate moderate\u2010to\u2010high risk people with diabetes to wear properly fitting, accommodative, therapeutic footwear, and consider coaching them to monitor foot skin temperature. Prescribe therapeutic footwear that has a demonstrated plantar pressure relieving effect during walking, to help prevent plantar foot ulcer recurrence. Consider advising people at low\u2010to\u2010moderate risk to undertake a, preferably supervised, foot\u2010ankle exercise programme to reduce ulcer risk factors, and consider communicating that a total increase in weight\u2010bearing activity of 1000 steps\/day is likely safe with regards to risk of ulceration. In people with non\u2010rigid hammertoe with pre\u2010ulcerative lesion, consider flexor tendon tenotomy. We suggest not to use a nerve decompression procedure to help prevent foot ulcers. Provide integrated foot care for moderate\u2010to\u2010high\u2010risk people with diabetes to help prevent (recurrence of) ulceration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These recommendations should help healthcare professionals to provide better care for persons with diabetes at risk of foot ulceration, to increase the number of ulcer\u2010free days and reduce the patient and healthcare burden of diabetes\u2010related foot disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dmrr.3651","type":"journal-article","created":{"date-parts":[[2023,6,11]],"date-time":"2023-06-11T13:15:57Z","timestamp":1686489357000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":232,"title":["Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2023 update)"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8357-9163","authenticated-orcid":false,"given":"Sicco A.","family":"Bus","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine Amsterdam UMC Location University of Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Movement Sciences Program Rehabilitation &amp; Development  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel C. N.","family":"Sacco","sequence":"additional","affiliation":[{"name":"Physical Therapy, Speech and Occupational Therapy Department School of Medicine University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4586-2910","authenticated-orcid":false,"given":"Matilde","family":"Monteiro\u2010Soares","sequence":"additional","affiliation":[{"name":"Portuguese Red Cross School of Health \u2013 Lisbon  Lisbon Portugal"},{"name":"MEDCIDS \u2013 Departamento de Medicina da Comunidade Informa\u00e7\u00e3o e Decis\u00e3o em Sa\u00fade Faculty of Medicine of the University of Porto  Porto Portugal"},{"name":"RISE@CINTESIS Faculty of Medicine Oporto University  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Raspovic","sequence":"additional","affiliation":[{"name":"Discipline of Podiatry School of Allied Health Human Services and Sport La Trobe University  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