The Spanish Diabetic Foot Project
The Spanish Diabetic Foot Project (2024) is an initiative by the EWMA Diabetic Foot Committee aimed at developing a unified, coordinated model of diabetic foot care across Spain. By connecting expert clinicians, healthcare facilities, and regional policymakers, the project seeks to address the needs of Diabetic Foot Syndrome (DFS) patients through consensus-based practical approaches and interregional collaboration. This project not only supports diabetic foot care within Spain but also contributes to innovation in care standards across Europe.
A study by Rubio et al. [1] highlights a significant need for this initiative, indicating that no more than one in four Spanish DFS patients receives care from a multidisciplinary team, as recommended by the International Consensus on the Diabetic Foot (ICDF).
The Spanish Diabetic Foot Project Members
José Luis Lázaro Martínez (Chair)
Albert Pérez Fernández
Almudena Cecilia-Matilla
Diana Tundidor Rengel
Esther Martínez Aguilar
Ferrán Pla
Gabriel Rivera San Martin
Héctor González de La Torre
Jorge Vilarino
Juan Francisco Jiménez García
Juan Pedro Sánchez Ríos
Luis de Benito
Sandra Redondo
Silvia Blasco Gil
Please note that this list is being updated regularly, and we expect additional members to confirm their participation soon.
The Diabetic Foot
The term “diabetic foot” refers to a range of complications that can affect individuals with diabetes, primarily due to poor blood circulation and nerve damage caused by prolonged high blood sugar levels. The most common complication is the diabetic foot ulcer (DFU), a wound or open sore that typically occurs on the bottom of the foot. These ulcers can develop without pain, making them particularly dangerous as patients may not notice them until they worsen. Untreated DFUs often lead to infection and, in severe cases, require amputation. Prevention, early detection, and timely intervention are crucial to managing diabetic foot complications and improving the quality of life for patients.
‘EVERY 20 SECONDS, SOMEWHERE AROUND THE WORLD SOMEONE LOSES THEIR LEG BECAUSE OF DIABETES.’ [2]
Diabetic foot complications are a major health issue worldwide. Up to one-third of people with diabetes may develop a foot ulcer during their lifetime, with a high risk of recurrence once healed. Diabetic foot ulcers are also a leading cause of non-traumatic lower extremity amputations. In addition to the personal toll, diabetic foot complications pose a substantial burden on healthcare systems due to the high costs associated with wound care, infection management, and surgical intervention.
The Diabetic Foot in Spain
In Spain, the management of diabetic foot complications presents a significant opportunity for improvement. As stated, only one in four patients with diabetic foot complications is treated by a multidisciplinary team—a model of care endorsed by the International Consensus on the Diabetic Foot (ICDF) [1). This gap in care highlights the urgent need for coordinated strategies that connect primary care providers with specialized services. Multidisciplinary teams, including endocrinologists, podiatrists, wound care specialists, and vascular surgeons, are crucial for holistic management. They can detect issues early, administer appropriate treatment, and educate patients, reducing the likelihood of complications and the healthcare burden associated with advanced diabetic foot disease [2,3].
The current approach to diabetic foot care in Spain would benefit from a more unified structure to ensure patients have seamless access to comprehensive care. While individual healthcare providers deliver valuable support, a lack of consistent, connected pathways can create challenges in delivering timely, specialized treatment and follow-up care. Developing more structured, collaborative systems could bridge these gaps, providing patients with the early intervention, coordinated treatment, and continuous support they need to achieve better outcomes and avoid preventable complications [4,5].
The Objectives
The Spanish Diabetic Foot Project is dedicated to building a sustainable, evidence-based framework to improve diabetic foot care across Spain. Through structured initiatives in data collection, standard-setting, and collaborative networks, this project seeks to elevate care quality and accessibility for patients with Diabetic Foot Syndrome nationwide.
Data Collection Questionnaire: Understanding the Current Landscape of DFS in Spain
To inform and support the Spanish Project, a national questionnaire will be conducted to provide a comprehensive view of diabetic foot care practices across Spain. The survey will gather valuable insights in four key areas:
- Current DFS Care Practices: Identifying providers of DFS care and the range of treatments available.
- Challenges and Gaps: Highlighting common obstacles that healthcare providers encounter in diabetic foot care.
- Regional Differences: Exploring variations in care approaches and resources across Spain’s regions.
- Future Needs: Understanding the resources, training, or tools that could enhance DFS care.
National Diabetic Foot Registry
This project also aims to explore the creation of a National Diabetic Foot Registry in Spain to document and monitor the current state of DFS care within the healthcare system. This registry would serve as an essential tool for tracking trends, identifying gaps, and promoting continuous improvement.
Establishing Basic Care Standards
Another key objective is to set a national minimum standard of care for DFS patients to ensure that consistent, high-quality treatment is accessible throughout Spain. By defining these core standards, the project seeks to create a unified approach to diabetic foot care across all regions.
Network of Diabetic Foot Care Centers
To foster collaboration and innovation in diabetic foot care, the project aims to establish a network of specialized Diabetic Foot Care Centers across Spain. These centers will support clinical trials, epidemiological studies, and the exchange of expertise, enabling a collaborative approach both within Spain and with international partners.
Upcoming meetings
Kick-Off Meeting for the Spanish Diabetic Foot Project – Madrid, December 12, 2024
The Diabetic Foot Committee will launch the Spanish Project, bringing together regional leaders, clinicians, and specialists in diabetic foot care from across Spain. This inaugural meeting invites heads of Spanish clinics and key opinion leaders in diabetic foot management to collaborate on creating a unified and effective approach to diabetic foot care in Spain. Attendance is by invitation only.
The objective of this meeting is to establish a framework similar to the Diabetic Foot Valley model in Tuscany, which enhances care pathways and outcomes for individuals at risk of diabetic foot complications. Attendees will discuss strategies for improving patient care, promoting early intervention, and building a strong network of expertise in diabetic foot management across Spain.
EWMA GNEAUPP Conference in Barcelona
The Spanish Diabetic Foot Project will convene during the upcoming EWMA GNEAUPP Barcelona Conference on 26-28 March 2025.
Industry supporters
The Spanish Project is kindly supported by the following companies:
Sources
Rubio JA, Aragón-Sánchez J, Jiménez S, Lozano F, Hernández S, Gámez F, et al. Diabetic foot care in Spain: survey of current practice. Diabet Med. 2014;31(6):656-60.
- Armstrong DG, Boulton AJM, Bus SA. Diabetic Foot Ulcers and Their Recurrence. N Engl J Med. 2017;376(24):2367-2375.
Hicks CW, Selvarajah S, Mathioudakis N, Sherman RL, Hines KF, Black JH III, et al. Burden of diabetic foot ulcers on quality of life for patients in the Medicare population. Diabetes Care. 2016;39(12):2113-5.
Van Netten JJ, Lazzarini PA, Armstrong DG, Bus SA, Fitridge R, Game F, et al. Diabetic foot disease: The impact of healthcare, social and cultural factors on outcomes in high-income countries. Diabet Med. 2018;35(8):922-30.
Zhu Z, Tang Z, Zhang Z, Zhang Y. Integrated care pathways for diabetic foot: a systematic review and meta-analysis. Int J Low Extrem Wounds. 2014;13(1):20-6.
