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

The iDEAL group has recommended the ACT NOW acronym to help both health professionals and people with diabetes to recognise the warning signs that might lead to amputation, and which if identified can be referred urgently to specialist multidisciplinary diabetes foot care teams for assessment and treatment.

This is especially timely with the increase in numbers of avoidable late referrals into multi-disciplinary diabetes foot care teams being reported and foot examinations not being routinely undertaken due to the remote nature of diabetes consultations in general practice since the start of the Covid-19 pandemic. 

iDEAL believe if the ACT NOW checklist is adopted into clinical practice that a 50% reduction in major amputations among people with diabetes can be achieved within five years.