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. 2023 Nov;60(11):1449-1469.
doi: 10.1007/s00592-023-02150-8. Epub 2023 Jul 25.

Development of the Italian clinical practice guidelines for the treatment of diabetic foot syndrome: design and methodological aspects

Matteo Monami  1   2 , Alessia Scatena  3 , Cesare Miranda  4 , Luca Monge  5 , Alessandro De Cassai  6 , Antonio Volpe  7 , Rodolfo Tramonta  8 , Gerardo Medea  9 , Corrado Bordieri  10 , Marco Falcone  11 , Laura Stefanon  12 , Andrea Bernetti  13 , Cristina Cappella  14 , Mauro Gargiulo  15 , Valentina Lorenzoni  16 , Germano Scevola  17 , Eugenio Stabile  18 , Benedetta Ragghianti  19 , Giovanni Antonio Silverii  19 , Roberto da Ros  20 , Marco Meloni  21 , Laura Giurato  21 , Giuseppe Murdolo  22 , Eleonora Bianchini  22 , Francesco Gaggia  22 , Carlotta Gauna  23 , Francesco Romeo  24 , Matteo Apicella  3 , Michele Mantuano  3 , Luigi Uccioli  21 , Cristiana Vermigli  22 ; Panel of the Italian Guidelines for the treatment of Diabetic Foot Syndrome and on behalf of SID and AMD
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Development of the Italian clinical practice guidelines for the treatment of diabetic foot syndrome: design and methodological aspects

Matteo Monami et al. Acta Diabetol. 2023 Nov.

Erratum in

Abstract

Aims: Diabetic foot syndrome (DFS) and its complications are a growing public health concern. The Italian Society of Diabetology (SID) and the Italian Association of Clinical Diabetologists (AMD), in collaboration with other scientific societies, will develop the first Italian guidelines for the treatment of DFS.

Methods: The creation of SID/AMD Guidelines is based on an extended work made by 19 panelists and 12 members of the Evidence Review Team. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology has been used to decide aims, reference population, and target health professionals. Clinical questions have been created using PICO (Patient, Intervention, Comparison, Outcome) conceptual framework. The definition of questions has been performed using a two-step web-based Delphi methodology, a structured technique aimed at obtaining by repeated rounds of questionnaires a consensus opinion from a panel of experts in areas wherein evidence is scarce or conflicting, and opinion is important.

Results: The mean age of panelists (26.3% women) was 53.7 ± 10.6 years. The panel proposed 34 questions. A consensus was immediately reached for all the proposed questions, 32 were approved and 2 were rejected.

Conclusions: The areas covered by clinical questions included diagnosis of ischemia and infection, treatment of ischemic, neuropathic, and infected ulcers, prevention of foot ulceration, organization and education issues, and surgical management. The PICO presented in this paper are designed to provide indications for healthcare professionals in charge of diabetic foot treatment and prevention, primarily based on clinical needs of people with diabetic foot syndrome and considering the existing organization of health care.

Keywords: Diabetes; Diabetic foot syndrome; Guidelines.

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