Doença do pé relacionada ao diabetes mellitus: evidências científicas, protocolos de manejo e a qualificação do(a) enfermeiro(a) no contexto brasileiro

Abstract

Diabetes Mellitus (DM) represents one of the main contemporary public health challenges, characterized as a chronic, multifactorial, and highly prevalent disease, especially in its type 2 form. Its complications, particularly those associated with the lower limbs, such as Diabetic Foot Disease (DFD) are among the most frequent causes of disability, prolonged hospitalizations, and non-traumatic amputations. The objective of this study was to understand the approach to the care of DFD considering the scientific evidence in the Brazilian context. This study is a scoping review, complemented by a documentary analysis of clinical protocols, guidelines, and manuals developed by the Ministry of Health, in addition to an evaluation of the National Curricular Guidelines that guide the training of nurses in Brazil. The results of this research show that diabetic foot disease is one of the main causes of non-traumatic amputations in Brazil, associated with high healthcare costs and a significant impact on quality of life. Multiple demographic, clinical, and socioeconomic risk factors were identified, notably advanced age, male sex, inadequate glycemic control, peripheral neuropathy, and regional inequalities. The North and Northeast regions showed greater vulnerability, reflecting differences in access to services and social determinants. The findings reinforce the need for integrated public policies that prioritize early screening, health education, and continuous multidisciplinary follow-up. A mismatch was also observed between theoretical knowledge and its practical application by nurses, which demands permanent investments in training and continuing education. Although the National Curriculum Guidelines offer a solid foundation, it is essential to strengthen teaching and practices focused on diabetes complications. Thus, professional qualification and evidence-based care are pillars for the prevention and effective management of DFD contributing to more effective, humanized, and equitable care.