Introduction: Diabetic foot ulcers (DFUs) are a debilitating complication of diabetes, and management by multidisciplinary foot teams has been shown to reduce serious sequelae, such as amputations. There are stark racial and ethnic disparities in morbidity and mortality from DFUs, and multidisciplinary care has been shown to reduce lower extremity amputations, length of hospital stays and readmissions. This is a review of the impact of multidisciplinary care on DFUs, particularly regarding social determinants of health, with an illustrative case. Case Presentation: This is a case of a 32-year-old African American male with Type 1 Diabetes, a history of poor glycemic control, attention deficit hyperactivity disorder, tobacco and marijuana use disorder, and multiple social and structural barriers to care. He presented with bilateral Wagner grade 3 DFUs with osteomyelitis to the emergency department, requiring hospitalization. Upon discharge, he was referred to a multidisciplinary diabetes clinic and received coordinated support from endocrinology, podiatry, vascular surgery, infectious disease, pedorthics, and behavioral health. Comprehensive evaluation, intensive wound care with adjuvant hyperbaric oxygen therapy, offloading, blood glucose management and medical source control of infection were established for his treatment plan. At the three-month follow-up, the patient’s wound beds had significantly improved, and his Hemoglobin A1c declined from 12.6% to 9.3%. The right plantar wound completely epithelialized, and the left foot wound showed 90% contracture. Review and Discussion: This case highlights the importance of integrated, multidisciplinary care for DFUs, particularly in addressing both the clinical and social drivers of complications from diabetes.

Esta revisión de literatura auscultó los hallazgos sobre el rol de la supervisión de Terapia Dialéctica Conductual (TDC) en la quemazón de estos terapeutas con la finalidad de guiar futuras investigaciones sobre métodos de supervisión clínica. Este artículo evalúa los factores protectores del modelo de supervisión individual y grupal de la TDC como herramienta para el manejo de la quemazón en diferentes tipos de proveedores de salud mental. La modalidad individual adiestra a las terapeutas en el manejo de clientes categorizados como retantes. Por otro lado, la modalidad grupal propicia un ambiente equilibrante entre lo personal (validación y percepción de logro) y lo profesional (menor estigma y apatía). Finalmente, sugerimos próximas áreas a investigar ya que encontramos una disponibilidad muy limitada en investigaciones iberoamericanas realizadas sobre este tema; con lo que, instamos a investigadores de España y Latinoamérica a iniciar su aportación investigativa.