What is a Diabetic Foot MDT?

MDT stands for multidisciplinary team. This is where you have people with different specializations looking at the patient. It does not necessarily mean that the patient has to be there in person, but the details are discussed. It also doesn't mean that you have to have all of those individuals present in the same room, say for example when the patient attends clinic, but usually what you'll have is a podiatrist, you'll have a diabetes specialist, you'll have a microbiologist, you'll have a vascular surgeon, you'll have a physiotherapist, an orthotist, and a radiologist. The radiologist will be someone who specializes in what's called musculoskeletal radiology, that is they're used to looking at bones. Now you'd think all radiologists must be used to looking at bones, they are. But on the other hand, there are some with particular specializations, and they can see lot just on a plain x-ray that other people would not and it saves you having unnecessary imaging that you might have to wait a long time for. You have a microbiologist there to help you decide on what type of antibiotics you may need and for how long. You have a vascular surgeon there to see whether you need to have tissue removed, what's called debridement, which a podiatrist can often do but if it's more specialised and especially if you need to improve the circulation to the foot for example you've done everything you can but the ulcer still isn't healing and you then do scans that show there's poor circulation a vascular surgeon gets involved you often have radiologists who are called interventional radiologists they can improve the circulation by going in through your arteries with what are called balloons and opening them up a bit like heart specialists do for you know coronary artery disease and then you have podiatrists obviously they're your first point of contact the blood the diabetes specialists who are there to often work in conjunction with the podiatrists and will be there to make decisions also on antibiotics what imaging to get whether or not you need to have offloading which means say for example putting you into a total contact class if you have Charcot foot disease, improving your blood glucose control because often patients who present to foot clinics have poor blood glucose control and this provides an opportunity for us to intervene, try and help the patient get better control of their diabetes, perhaps make them think about certain therapies that they have put off taking up in the past such as insulin and this may be the point where they make a decision that that will have beneficial effects for other aspects of their diabetes. So often what we have, certainly in our trust, we have a meeting every Friday morning, we have a list of patients, we will look at their images, we will look at their blood test results, we will look at their microbiology results and we will come to a conclusion. We'll then feed that back to the people who are looking after them and make decisions based on all all of that, and that could include that the patient needs to have surgery and we'll bring the patient in in a timely manner to provide that.