Why the Diabetic Foot Valley Project is an initiative to be inspired by: Bridging the Gap between Theory and Practice

17. December 2024

At DFCon 2024 in Anaheim, CA, the American Limb Preservation Society (ALPS) honored Prof. Dr. Alberto Piaggesi with the Edward James Olmos Award for Advocacy in Limb Preservation. Celebrated for his visionary contributions to diabetic foot care, Prof. Piaggesi has established a benchmark for integrated care through initiatives like the Diabetic Foot Valley Project in Tuscany, Italy.

“Collaborating across disciplines and borders is crucial in tackling the complex challenges of diabetic foot management, and this recognition further fuels our mission to bring effective care to those most in need,” stated Prof. Piaggesi when he received the award.

But what makes the Diabetic Foot Valley Project remarkable, and how can others leverage its lessons to advance limb preservation efforts?

Addressing a Crisis in Diabetic Foot Care in Tuscany, Italy

 In Tuscany, where an estimated 24,000 diabetic patients are affected by DFS, disparities in treatment outcomes have persisted despite the introduction of regional care guidelines in 2003.

The COVID-19 pandemic further worsened the situation, contributing to a 47% increase in amputations and a 62% rise in Diabetic Foot-related deaths between 2019 and 2021.

Launched in July 2022, the Diabetic Foot Valley Project initiated by Prof. Dr. Alberto Piaggesi sought to address these challenges by transforming guidelines into an actionable, bottom-up, integrated care model for diabetic foot management. 

Patient Resources

The project unites healthcare professionals across Tuscany into a regional care network focused on improving outcomes for Diabetic Foot patients. Its primary goals include:

  • Guideline Implementation: Adopting international and regional standards in everyday clinical settings.
  • Integrated Care Networks: Establishing centers of excellence surrounded by interrelated units to deliver comprehensive care.
  • Standardized Practices: Aligning diagnostic and treatment protocols across facilities.
  • Data Collection and Analysis: Developing a registry to monitor clinical, organizational, and economic aspects of Diabetic Footcare.
  • Professional Development: Offering workshops, audits, and scientific meetings to advance skills and foster collaboration among healthcare providers.
Impact and Achievements

In its first year, the Diabetic Foot Valley Project has achieved notable progress:

  • Expanded Network: 14 clinics have joined the initiative.
  • Research and Development: Three clinical trials are underway, supported by regulatory and investment agencies.
  • Data Infrastructure: A patient registry is in development, promising enhanced evidence-based care.
  • Recognition: The project has gained visibility across Europe, positioning Tuscany as a leader in integrated DFS care.

The project has also served as an inspiration to found and develop the model in other countries and regions, most recently The Spanish Diabetic Foot Project established by the Diabetic Foot Committee of the European Wound Management Association (EWMA).

Dr. José Luis Lázaro-Martínez, EWMA Diabetic Foot Committee Chair shares:

“As a testament of the achieved success in Tuscany we are now bringing the Diabetic Foot Valley approach to Spain in a new EWMA project named – The Spanish Project: A National Vision for Diabetic Foot Care – which aims to develop a unified and coordinated model of diabetic foot care across Spain.”

A Blueprint for the Future

The Diabetic Foot Valley Project aligns with ALPS’s mission to reduce preventable amputations and serves as a compelling example of how data-driven, multidisciplinary collaboration can lead to measurable improvements in patient outcomes.

ALPS Founding President Dr. David G. Armstrong highlights the importance of the project:

“Initiatives like the Diabetic Foot Valley Project show us how targeted, integrated approaches can drastically reduce preventable amputations. It’s a model of collaboration that aligns perfectly with the goals of ALPS. Most compelling is the team approach to Diabetic Foot care, which is also the core of our work at ALPS”.

For further insights, explore the following resources:

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