The step-by-step program to lower the number of diabetic foot amputations in Mexico

Abstract

Background: The implementation of the “Step by Step” educational program to reduce diabetic foot events has reported favorable results in several countries. Objective: To describe the implementation process of the program to reduce diabetic foot amputations in Mexico and the application of essential indicators for monitoring. Materials and methods: From June 2018 to October 2022, basic and advanced courses on the prevention and treatment of diabetic foot were taught. Health professionals attended and reported the actions they carried out 1 year later. In a clinical center, the essential indicators were recorded during 5 years of follow-up in foot care. Results: Ninety-two health-care professionals were trained in face-toface mode and 638 in virtual mode. Fifty-two replicas of courses were reported, with a record of 1,379 attendees. Sixteen sites sent their actions, being the most frequent the review of > 80% of patients, standardization of evaluation procedures and registration of indicators in files, courses for nursing staff and patients, and preparation of didactic material. In the Center of Comprehensive Care for the Patient with Diabetes, 14 indicators were implemented, and in 5 years no diabetic foot amputation has been reported. Conclusion: It is feasible to implement an educational strategy for the prevention of timely care of the diabetic foot to reduce the rate of amputations in our environment.

Keywords

• Diabetic foot. Prevention. Amputations.