What This Means
This research suggests that people with diabetes who are at risk of developing foot ulcers face significant gaps in the healthcare they receive, despite guidelines meant to prevent these serious complications. Using a structured group process called Concept Mapping, researchers gathered patients, healthcare workers, and researchers together in Sweden to brainstorm and then prioritize ideas for improving care. From 83 ideas, five main themes emerged, covering topics like how healthcare professionals examine feet, sharing knowledge, access to foot specialists (podiatrists), fairness in care, and support for patients managing their own foot health.
The most highly prioritized improvements identified were: having timely access to a podiatrist when foot problems appear, being able to get help quickly when issues arise, and receiving clear information from healthcare providers about why good foot care matters. These top priorities were both considered highly feasible and extremely important by the participants. Participants also emphasized the value of supporting patients in caring for their own feet and maintaining personal, individualized interactions with healthcare providers even as digital health tools become more common.
This research suggests that simply having guidelines is not enough — patients and providers alike see real-world barriers to foot ulcer prevention, particularly around specialist access and timely responses to emerging problems. The findings point to practical steps health systems could take, such as improving pathways to podiatry care and increasing foot health education for both patients and non-specialist healthcare workers, which could potentially reduce the serious consequences of diabetic foot ulcers, including infections and amputations.