Best practice recommendations for the Prevention and

     Management of Diabetic Foot Ulcers


Diabetes mellitus (DM) is a metabolic disorder characterized by hyperglycemia that
leads to microvascular, macrovascular and neuropathic complications. In 2016, there
were 11 million Canadians living with type 1, type 2 or pre-diabetes, and every three
minutes another Canadian is diagnosed. Certain populations are at higher risk for
developing type 2 DM, including those of Asian, African, Hispanic and Indigenous decent.
The rates of DM are three to five times higher in Indigenous populations, an issue
compounded by unique barriers to care including, but not limited to, a lack of cultural
competency among health-care providers, jurisdictional confusion, limited access to
care, geographical location and language barriers.


Foot health should be a major consideration for people with diabetes and for those
who care for them. Foot complications in this high-risk population can lead to a cascade
of negative complications, potentially resulting in loss of limb and life.
The lifetime risk for foot ulceration in people with diabetes is 15 to 25%. According to
the International Diabetes Federation, persons with diabetes are 15 to 40 times more
likely to require lower-leg amputation compared to the general population. Approximately
85% of amputations are preceded by the development of a neuropathic foot


Following a lower-limb amputation, people with diabetes not only suffer the
clinical and psychological consequences of limb loss, but also have a five-year mortality
rate of 50%. This is a higher mortality rate than is seen in breast cancer in females,
prostate cancer in males or lymphoma … read more