[Peripheral artery disease and diabetes: complex multidisciplinary care for an increasing number of patients]. / Perifeer arterieel vaatlijden bij diabetes.

The forthcoming increase in the number of people with diabetes mellitus (DM) is likely to lead to an absolute and relative increase in the number of people with a combination of DM and peripheral artery disease (PAD). Due to different pathophysiological processes and presentation, diagnosis and treatment in these patients are more complicated compared to non-DM related PAD. Understanding the differences, pitfalls and concerns in patients with combined DM-PAD would result in better care for these patients, who are at high risk of cardiovascular comorbidities, mortality and amputation. Introduced by two case reports, we provide an overview of current guidelines, recent literature and innovations to address these critical issues.

[Photographic foot scanner for the early diagnosis of diabetic foot]. / Fotografische voetscanner voor vroege diagnostiek diabetische voet.

Early recognition of foot ulcers and pre-ulcerative lesions in diabetic patients is important for the prevention of severe complications such as infection and amputation. The photographic foot-imaging device is a new technique intended as a home-monitoring system for the early diagnosis of signs of diabetic foot disease. The patient regularly takes pictures of the plantar foot surface which a trained healthcare professional remotely assesses. In the case of diagnosed foot problems, the patient is referred for treatment. This telemedical approach is primarily intended for patients who have previously had a foot ulcer or amputation. In particular, patients who are limited in inspecting their own feet may profit from this approach. The diagnosis of foot problems from photographs produced by the system has been proven to be both valid and reliable. If future studies demonstrate the efficacy and cost-effectiveness of this approach in preventing severe foot complications, it may become an integral part of foot care for high-risk diabetic patients.