This guideline covers preventing and managing foot problems in children, young people and adults with diabetes. It aims to reduce variation in practice, including antibiotic prescribing for diabetic foot infections.
Fluoroquinolone antibiotics: In January 2024, the MHRA published a Drug Safety Update on fluoroquinolone antibiotics. These must now only be prescribed when other commonly recommended antibiotics are inappropriate. NICE is assessing the impact of this warning on recommendations in this guideline.
For information on related topics see our cardiometabolic disease prevention and treatment summary page.
In January 2023, we reviewed recent evidence and decided that no changes were needed to our guidance on risk assessment tools for diabetic foot problems and frequency of diabetic foot reviews. Recommendations are marked  if the evidence was reviewed.
The guideline includes recommendations on:
- care in hospital within the first 24 hours
- care across all care settings
- assessing the risk of developing a diabetic foot problem
- diabetic foot problems
- diabetic foot ulcer
- diabetic foot infection
- Charcot arthropathy
See a 3-page visual summary of the antimicrobial prescribing recommendations, including tables to support prescribing decisions.
Who is it for?
- Healthcare professionals caring for people with diabetes
- Commissioners and providers of diabetes foot care services
- People with diabetes, and their families and carers
Guideline development process
This guideline updates and replaces NICE guidelines CG10 (January 2004) and CG119 (March 2011), and the recommendation on foot care in NICE guideline CG15 (July 2004).
NICE worked with Public Health England to develop this guidance.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.