ACT NOW in diabetes and foot assessments: an essential service

The iDEAL (Insights for Diabetes Excellence, Access and Learning) group has put forward a series of recommendations to improve foot care and education, promote more effective and timely referral when needed, and to reduce the unacceptable numbers of major amputations in people with diabetes.

This is especially timely with the increase in numbers of avoidable late referrals into multidisciplinary diabetes foot care teams being reported and foot examinations not being routinely undertaken (Rogers et al, 2020) due to the remote nature of diabetes consultations in general practice since March 2020 and the first and second lockdown.

The iDEAL group has recommended an acronym of ACT NOW to help both health professionals and people with diabetes to recognise the warning signs that might lead to amputation, which, if identified earlier, can be referred urgently to specialist multidisciplinary diabetes foot care teams for assessment and treatment. iDEAL believes that if this ACT NOW assessment can become routine in clinical practice that a 50% reduction in major amputations among people with diabetes can be achieved within 5 years (Edmonds et al, 2019; Edmonds et al, 2020).