Reducing the Diabetes Footprint: A Call for Aotearoa New Zealand Diabetic Foot Guidelines.

Diabetes-related foot disease (DFD) affects an estimated 110,000 people in Aotearoa New Zealand (Aotearoa NZ) and is one of the leading causes of the national disease burden. While guideline-based care has been found to significantly reduce DFD burdens around the world, Aotearoa NZ lacks national DFD guidelines. Instead, Aotearoa NZ clinicians tend to use either international guidelines or fragmented regional pathways of varying quality which result in variability in clinical practice. Given the higher impacts of DFD on Māori and Pacific peoples, and those in socioeconomically deprived or rural areas, national DFD guidelines incorporating Indigenous knowledge are urgently needed in Aotearoa NZ. We call for the urgent development of Aotearoa NZ DFD guidelines and propose methods to co-develop evidence-based guidelines integrating clinical expertise with Indigenous perspectives. This approach will enhance consistency, improve health outcomes, and support equitable DFD care in Aotearoa NZ.