Outcomes of structural preventive diabetic foot care region Zwolle 2017-2018

Since 2002 in the region of Zwolle (in the north east of the Netherlands) the diabetes care was well structured. Diabetes Specialized nurses were trained to counsel persons with a diagnosis diabetes. At first, secondary care specialized nurses (Diabetes VerpleegKundigen: DVKs) were involved taking care – initially – of secondary care patients, and –for a transition period - of primary care patients, but after some years, primary care nurses trained for diabetes care (Praktijk Ondersteuners Huisarts: POHs) took over as the coordinator of care in integrated primary care diabetes care. A well-structured foot exam was part of this care system. Patients with higher risk on foot ulcers were referred to the podiatrist for preventive foot care. The podiatrists became supervisor of the pedicures in patients with DM. The goal of the project was to reduce the number (and the level) of amputations in persons with diabetes.
In this study, we combine all available data of preventive foot care (screening by DVKs and POHs, visits to pedicures and podiatrists) with the data of amputations in the Isala hospital in Zwolle during the years 2017 and 2018. The main question with this assessment is: what are the results / outcomes of structured preventive footcare on number and extentof amputations in people with diabetes?

No specific hypothesis involved. There is a definite need to assess the effects of well structured diabetic foot care on the number and level of amputations within a specified region.

july analysing data, publishing september 2021