Podiatry is a field of medicine that focuses on preventing, diagnosing, and treating conditions associated with the foot and ankle. Common chronic foot conditions for those with diabetes include ulcers, poor circulation, nail issues, skin rashes, loss of sensation, and weight-bearing imbalances. Amputation of a foot or leg is a complication of diabetes that most often begins with a foot ulcer.
While licensing requirements do vary from province to province, podiatrists ― or Doctors of Podiatric Medicine ― are highly trained practitioners. In Ontario, podiatrists are authorized to communicate a diagnosis, perform surgical procedures, administer injections into the feet, and prescribe medication. Currently, there is no certification process for foot care nursing in Canada.
The number of podiatrists in Canada is small. For example, there are 70 podiatrists working in Alberta, 70 in Ontario, and 80 in British Columbia. Family physicians, nurses, and other allied health professionals also provide routine foot care. As the number of Canadians with diabetes is growing each year, an increased demand for foot care can be expected. Is there clinical evidence to support the delivery of foot care by podiatrists, as compared with other health professionals?
A limited literature search was conducted of key resources, and titles and abstracts of the retrieved publications were reviewed. Full-text publications were evaluated for final article selection according to predetermined selection criteria (population, intervention, comparator, outcomes, and study designs).
The literature search identified 174 citations, with no additional articles identified from other sources. After screening the abstracts, no potentially relevant studies were selected for full-text review, nor did any meet the criteria for inclusion in this review.
- No clinical evidence was found comparing the delivery of foot care by a podiatrist with delivery by other health professionals.
- Diabetic foot care by an interdisciplinary team has been shown to have a positive impact.
- As the incidence of diabetes grows, research into the optimal delivery of foot care for adults with diabetes may be warranted.