Diabetic Foot Management During the COVID-19 Pandemic

The COVID-19 pandemic imposed profound disruptions on the multidisciplinary care of diabetic foot disease, exposing vulnerabilities in traditional clinic-based models and accelerating shifts towards remote monitoring and digital interventions. Before the pandemic, regular in-person assessment, timely debridement, vascular imaging and offloading strategies underpinned limb preservation. Travel restrictions, redeployment of healthcare staff and patient reluctance to attend hospitals led to delays in presentation, more advanced ulceration at first contact and a higher burden of infection. Centres that rapidly implemented virtual triage, telehealth education and community nurse-assisted wound care demonstrated that structured remote workflows can mitigate the risks of late presentation while preserving key outcomes such as wound closure rates and amputation incidence. The pandemic also highlighted stark inequities: younger patients and those from socially deprived backgrounds experienced disproportionate adverse events. As health systems recover, hybrid models combining digital surveillance with targeted face-to-face interventions, strengthened community partnerships and streamlined pathways for revascularisation are emerging as durable advances. These innovations promise to enhance global access, reduce costs and improve patient empowerment in diabetic foot management well beyond the acute phase of the pandemic.

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Diabetic Foot Management During the COVID-19 Pandemic publication trend

The graph below shows the total number of articles in diabetic foot management during the covid-19 pandemic across all publications each year (not limited to Nature Index journals).

Technical terms

Diabetic foot ulcer: a full-thickness wound on the foot of a person with diabetes, often complicated by neuropathy and vascular insufficiency.

Neuro-ischaemic ulcer: an ulcer in which both nerve damage and reduced blood flow contribute to tissue breakdown.

Telehealth: provision of healthcare services and education at a distance using digital communication technologies.

Revascularisation: surgical or endovascular procedures to restore adequate blood supply to ischaemic tissue.

Offloading: strategies to redistribute pressure away from an ulcer site, often via specialised footwear or orthotic devices.

References

1. Diabetic Foot Disease during the COVID-19 Pandemic. Medicina (2021).
2. Virtual triage and outcomes of diabetic foot complications during Covid-19 pandemic: A retro-prospective, observational cohort study. PLOS ONE (2021).
3. Evidence of greater severity of diabetic foot ulcers during COVID‐19 pandemic: A real‐life single‐centre cohort study. Diabetes/Metabolism Research and Reviews (2023).
4. Breakdown of Diabetic Foot Ulcer Care during the First Year of the Pandemic in Poland: A Retrospective National Cohort Study. International Journal of Environmental Research and Public Health (2022).
5. A Nurse-Led Telehealth Program for Diabetes Foot Care: Feasibility and Usability Study. JMIR Nursing (2023).
6. Vascular service provision during the COVID-19 pandemic worsened major amputation rates in socially deprived diabetic populations. Frontiers in Endocrinology (2024).