Integrated care pathway for the management of diabetic foot disease: a position statement from the Italian Diabetic Foot Study Group.

Diabetic foot is one of the most serious chronic complications of diabetes mellitus and reflects the systemic burden of the disease. Preventive strategies and structured management pathways are therefore essential elements of diabetes care. Lifetime occurrence of foot ulceration has been reported in nearly one-third of individuals with diabetes, and these lesions account for most non-traumatic lower-extremity amputations. Furthermore, the estimated five-year mortality following ulceration is 30%. This document aims to ensure an appropriate, multidisciplinary care pathway for patients with diabetic foot, tailored to clinical complexity and aligned with the different levels of care of Italian diabetes centers. The integrated model of diabetic foot care is based on the level of care that diabetes centers (local and hospital) can provide, including available personnel, expertise, and diagnostic and therapeutic resources to manage varying degrees of clinical complexity. Accordingly, three levels of care complexity, low, medium, and high, have been defined, with corresponding key diagnostic and therapeutic activities and healthcare professionals involved.