{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:22:15Z","timestamp":1783506135343,"version":"3.55.0"},"reference-count":96,"publisher":"MDPI AG","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAPMA"],"published-print":{"date-parts":[[2010,9]]},"abstract":"<jats:p>This historical perspective highlights some of the pioneers, milestones, teams, and system changes that have had a major impact on management of the diabetic foot during the past 100 years. In 1934, American diabetologist Elliott P. Joslin noted that mortality from diabetic coma had fallen from 60% to 5% after the introduction of insulin, yet deaths from diabetic gangrene of the lower extremity had risen significantly. He believed that diabetic gangrene was preventable. His remedy was a team approach that included foot care, diet, exercise, prompt treatment of foot infections, and specialized surgical care.<\/jats:p>\n                  <jats:p>The history of the team approach to management of the diabetic foot chronicles the rise of a new health profession\u2014podiatric medicine and surgery\u2014and emergence of the specialty of vascular surgery. The partnership among the diabetologist, vascular surgeon, and podiatric surgeon is a natural one. The complementary skills and knowledge of each can improve limb salvage and functional outcomes. Comprehensive multidisciplinary foot-care programs have been shown to increase quality of care and reduce amputation rates by 36% to 86%. Development of distal revascularization techniques to restore pulsatile blood flow to the foot has also been a major advancement.<\/jats:p>\n                  <jats:p>Patients with diabetic foot complications are among the most complex and vulnerable of all patient populations. Specialized diabetic foot clinics of the 21st century should be multidisciplinary and equipped to coordinate diagnosis, off-loading, and preventive care; to perform revascularization procedures; to aggressively treat infections; and to manage medical comorbidities. (J Am Podiatr Med Assoc 100(5): 317\u2013334, 2010)<\/jats:p>","DOI":"10.7547\/1000317","type":"journal-article","created":{"date-parts":[[2014,4,1]],"date-time":"2014-04-01T09:50:36Z","timestamp":1396345836000},"page":"317-334","source":"Crossref","is-referenced-by-count":11,"title":["History of the Team Approach to Amputation Prevention"],"prefix":"10.3390","volume":"100","author":[{"given":"Lee J.","family":"Sanders","sequence":"first","affiliation":[{"name":"Podiatry Service, Veterans Affairs Medical Center, Lebanon, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Robbins","sequence":"additional","affiliation":[{"name":"Veterans Health Administration Headquarters Podiatry Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael E.","family":"Edmonds","sequence":"additional","affiliation":[{"name":"Diabetic Foot Clinic, King\u2019s College Hospital, London, England."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"R1","year":"1981","unstructured":"Davidson JK, Alogna M, Goldsmith M, et al: \u201cAssessment of Program Effectiveness at Grady Memorial Hospital-Atlanta,\u201d in Educating Diabetic Patients, ed by G Steiner, PA Lawrence, p 329, Springer Publishing Co, New York. ,1981. ."},{"key":"R2","series-title":"Q J Med","first-page":"763","volume":"60","year":"1986","unstructured":"Edmonds ME, Blundell MP, Morris ME, et al: Improved survival of the diabetic foot: the role of a specialized foot clinic. .Q J Med60::763. ,1986. .3774959"},{"key":"R3","series-title":"Diabetologia","first-page":"844","volume":"43","year":"2000","unstructured":"Holstein P, Ellitsgaard N, Olsen BB, et al: Decreasing incidence of major amputations in people with diabetes. .Diabetologia43::844. ,2000. .10952455"},{"key":"R4","series-title":"Diabetes Care","first-page":"99","volume":"31","year":"2008","unstructured":"Krishnan S, Nash F, Baker N, et al: Reduction in diabetic amputations over 11 years in a defined U.K. population: benefits of multidisciplinary team work and continuous prospective audit. .Diabetes Care31::99. ,2008. .17934144"},{"key":"R5","series-title":"Diabet Med","first-page":"770","volume":"12","year":"1995","unstructured":"Larsson J, Apelqvist J, Agardh CD, et al: Decreasing incidence of major amputation in diabetic patients: a consequence of a multidisciplinary foot care team approach?. 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