Assess and document the size, depth, and position of the diabetic foot ulcer using a standardised system such as SINBAD or the University of Texas classification system NICE NG19.
Offer standard care treatments including offloading, control of foot infection, control of ischaemia, wound debridement, and appropriate wound dressings NICE NG19.
Use non-removable casting to offload plantar neuropathic, non-ischaemic, uninfected forefoot and midfoot ulcers, or an alternative device until casting can be provided NICE NG19.
Consider negative pressure wound therapy after surgical debridement, on advice from the multidisciplinary foot care service NICE NG19.
When deciding on dressings and offloading, consider the clinical assessment, patient preferences, and use the lowest-cost appropriate devices and dressings NICE NG19.
Refer limb-threatening or life-threatening diabetic foot problems immediately to acute services and inform the multidisciplinary foot care service for urgent assessment and treatment planning NICE NG19.
For other active diabetic foot problems, refer the patient within 1 working day to the multidisciplinary foot care service or foot protection service for triage within 1 further working day NICE NG19.
Provide patient education about foot care, signs of infection, foot emergencies, and footwear advice, emphasizing the importance of blood glucose control NICE NG19.