Abstract:
The International Working Group on the Diabetic Foot (IWGDF) has consistently published evidence-based guideline recommendations on the prevention and management of diabetes-related foot complications. In 2023, the group published their first guidelines on the diagnosis and treatment of Charcot neuro-osteoarthropathy (CNO) in persons with diabetes. The guidelines highlight 26 recommendations based on 4 categories: diagnosis, identification of remission, treatment, and prevention of re-activation. As reviewed in the guidelines, there are 2 recommendations suggesting the use of temperature assessment and monitoring as a tool for management of patients with CNO. Utilizing the systematic review and the GRADE system of evaluation, the authors deemed the level of evidence around temperature monitoring and Charcot to be low with a conditional recommendation for use. The purpose of this manuscript is to summarize the IWGDF guidelines while highlighting the role of foot temperature monitoring. Several case examples are given to illustrate the use of temperature monitoring in patients with CNO. Until there are guidelines determining active vs quiescent CNO, skin temperature monitoring can be a fast, easy-to-use, and effective tool for the clinician.
摘要:
糖尿病足国际工作组(IWGDF)一直在发布有关预防和管理糖尿病相关足部并发症的循证指南建议。2023年,该小组发布了有关糖尿病患者Charcot神经骨关节病(CNO)诊断和治疗的第一份指南。该指南突出了基于4类的26项建议:诊断,缓解的鉴定,治疗,和防止重新激活。如准则所述,有2条建议使用体温评估和监测作为CNO患者管理的工具.利用系统评价和等级评价体系,在有条件推荐使用时,作者认为围绕温度监测和Charcot的证据水平较低.本手稿的目的是总结IWGDF指南,同时强调足部温度监测的作用。给出了几个案例来说明温度监测在CNO患者中的应用。在有指导方针确定活跃与静止的CNO之前,皮肤温度监测可以是一个快速,易于使用,和临床医生的有效工具。