Diabetic Foot Disease, Self-Care and Clinical Monitoring in Adults with Type 2 Diabetes: The Alberta’s Caring for Diabetes (ABCD) Cohort Study

Background: Diabetic foot disease (DFD) is a major challenge for the healthcare system, with enormous economic consequences for people living with diabetes, their families, and society, affecting both quality of life and quality of care. The study aim was to assess the level of awareness of DFD amongst patients with type 2 diabetes mellitus (T2DM).Methods: An observational descriptive cross-sectional study was conducted at the chronic outpatients department of a regional hospital in Durban, South Africa.Results: Two hundred participants with T2DM participated in the study. Ninety-one per cent of participants were either overweight or obese. Ninety-two per cent of participants had concomitant hypertension (57.5%), dyslipidaemia (26.7%) and eye disease (7.2%). Seventy-six per cent reported altered sensation in their lower limbs, and 90% reported having no previous DFD education. Only 22.2% of participants reported having examined their feet, but only when they experienced a problem. Participants achieved mediocre scores for knowledge (mean 4.45, standard deviation (s.d.) 2.201, confidence interval (CI) 4.2–4.7) and practice (mean 11.09, s.d. 2.233, CI 10.8–11.5) on diabetic foot care (DFC). Those who had a higher level of education and who were less than 65 years old had a significantly better score for previous foot care education (p < 0.05).Conclusion: The study demonstrated that awareness of DFD was suboptimal, based on current DFC guidelines. To minimise the burden of DFD, improved screening and prevention programmes as well as patient education should be provided to T2DM patients, whilst maintaining an aggressive approach to risk factor modifications, footwear and identifying the at-risk foot.

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A Retrospective Study Assessing the Risk Factors of Type 2 Diabetes Mellitus Linked to Diabetic Foot Ulcer Incidence in Jiaxing, China

10.21203/rs.3.rs-924121/v1 ◽

2021 ◽

Author(s):

Qiang Zhou ◽

Minjie Mao ◽

Yichuan Shao ◽

Danlu Yu ◽

Shengjie Tang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Diabetic Foot ◽

Protective Factor ◽

Course Of Disease ◽

Diabetic Foot Disease ◽

Independent Risk Factors ◽

Foot Disease

Abstract Objective: Diabetic foot (DF) is one of the common serious complications of diabetes, which is an important cause of death and disability, and is associated with diabetic vascular disease and diabetic neuropathy. The purpose of this study was to assess the incidence and risk factors for diabetic foot among a diabetic population. Methods: The study was a retrospective cohort review. The population studied was 348 male examinees of type 2 diabetes mellitus (DM), in which age-matched equal examinees (174 patients each) were with diabetic foot (DF Group) and with no indication of diabetic foot (non-DF group), hospitalized in the same year at The First Hospital of Jiaxing, China. Medical records were reviewed to collect clinical profile, including duration of disease, smoking, previous diabetic foot incidence, and medication (such as metformin). Categorical data between groups were analyzed using chi-square test (χ2). Unconditional logistic regression analysis was used for multi-factor analysis to identify the risk factors of diabetic foot. Results: Comparing the baseline data of DF Group and non-DF Group, age, course of disease, LDL-C and use of metformin showed no significant difference (P >0.05). The results of the logistic regression analysis showed that smoking history (OR=1.88, P=0.020), previous diabetic foot history (OR=2.290, P=0.016), Hcy (OR=1.194, p≤0.001) were independent risk factors for diabetic foot disease, and HgB (OR =0.984, P=0.021) was the protective factor of diabetic foot disease in male subjects. Age (OR=0.985, P=0.304), course of disease (OR=1.048, P=0.233), history of metformin use (OR=0.851, P=0.509), HbA1c (OR=1.302, P=0.059), LDL-C (OR=0.936, P=0.698), Creatinine (OR =1.010, P=0.326), and ALB (OR =0.943, P=0.084) were not significantly correlated with diabetic foot disease. Conclusions: Smoking, previous diabetic foot history, and homocysteine are independent risk factors for diabetic foot disease. HgB is the protective factor of diabetic foot disease in male patients.

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Risk factors for diabetic foot complications among patients with type 2 diabetes in Austria–A registry‐based retrospective cohort study

Endocrinology Diabetes & Metabolism ◽

10.1002/edm2.286 ◽

2021 ◽

Author(s):

Sophia Rossboth ◽

Benedikt Rossboth ◽

Hans Schoenherr ◽

Monika Lechleitner ◽

Willi Oberaigner

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Diabetic Foot ◽

Retrospective Cohort ◽

Foot Complications

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Group-Based Education Program on Self-Care toward Reduction of Diabetic Foot Risk on Type-2 Diabetes Mellitus Patients

Indian Journal of Public Health Research & Development ◽

10.37506/ijphrd.v11i4.7754 ◽

2020 ◽

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Education Program ◽

Diabetic Foot ◽

Self Care

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Omentin-1 and diabetic foot

The International Journal of Lower Extremity Wounds ◽

10.1177/15347346211069813 ◽

2022 ◽

pp. 153473462110698

Author(s):

Tsvetan Gatev ◽

Viktoriya Byalkova ◽

Ivan Poromanski ◽

Tsvetelina Velikova ◽

Dobrin Vassilev ◽

...

Keyword(s):

Diabetic Foot ◽

Metabolic Disorders ◽

Bioelectrical Impedance ◽

Cross Sectional Study ◽

Limited Data ◽

Elisa Method ◽

Cross Sectional ◽

Diabetic Foot Disease ◽

Foot Disease

Introduction: Diabetic foot disease is an advanced complication of diabetes mellitus, which is associated with severe invalidization and high mortality rate among affected people. Many factors are involved in its pathogenesis but not all of them are fully elucidated. Objectives: Adipose tissue and its hormones – adipokines, are related to diabetic complications and metabolic disorders. Until now, there are limited data on their role in diabetic foot. The aim of this cross-sectional study is to determine the levels of the adipokine omentin-1 in people with and without diabetic foot disease and to look for its potential involvement in this complication. Methods: Eighty patients with type 2 diabetes and mean age of 60.8±10.5 years were included in this study. They were divided into two groups: with (n=36) and without (n=44) diabetic foot disease. Standard antrometric, clinical and laboratory tests were made. Body composition was analyzed by bioelectrical impedance based device. Serum omentin-1 was measured using ELISA method. Results: Levels of omentin-1 were significantly higher among people with diabetic foot disease (700.2±345.1 ng/ml), compared to the other group (560.2±176.7 ng/ml). This difference remained significant even after adjusting for potential confounders. In a regression model omentin-1 proved its predictive value for development of diabetic foot. Conclusion: Adipokines, and particularly omentin-1, might be included in the pathogenesis of diabetic foot disease.

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Benefits of Hydrocolloid-Absorbent Dressings in “Diabetic Foot” Therapy

Acta Medica Transilvanica ◽

10.2478/amtsb-2020-0022 ◽

2020 ◽

Vol 25 (2) ◽

pp. 22-25

Author(s):

Denisa Tănăsescu

Keyword(s):

Diabetic Foot ◽

Conservative Therapy ◽

Therapeutic Option ◽

Therapeutic Education ◽

Varicose Ulcer ◽

Patients With Diabetes ◽

Diabetic Foot Disease ◽

Foot Disease ◽

The Right

AbstractThe incidence of diabetes is constantly increasing, so in 2014 about 8, 5% of adults over the age of 18 had diabetes worldwide. Also mortality in patients with diabetes is increased, only in 2015 being the direct cause for 1.6 million deaths worldwide. Worldwide, there are currently 425 million people living with diabetes; by 2045, 629 million people are expected to have diabetes. The authors present the case of patient I.A. 46 years old, male, from urban area, known with type 2 diabetes mellitus insulinotreated, secondary to acute pancreatitis, necrotico-haemorrhagic, operated on antecedents, which is presented in our service accusing spontaneous sensitivity and palpation of the lower limb right, premaleolar ulceration on the inner face of the lower right limb, with Celsian signs at this level, paresthesias at the level of the right leg, muscular weakness, weight loss. Alternative absorbent-hydrocolloid therapy is a feasible therapeutic option for patients with varicose ulcer wounds, especially in those with diabetic background. The combination of targeted antibiotic therapy, systemic treatment, local surgical treatment followed by local colloidal-absorbent treatment has very good results in a much shorter time than conventional, conservative therapy. Prophylaxis of any “diabetic foot” disease is extremely important. Therapeutic education is a major role in preventing the complications of diabetes. The diabetic patient should be trained and learned in order to prevent problems that may occur in the foot.

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Social Deprivation and Incident Diabetes-Related Foot Disease in Patients With Type 2 Diabetes: A Population-Based Cohort Study

10.2337/figshare.13476807.v1 ◽

2021 ◽

Author(s):

Jenny Riley ◽

Christina Antza ◽

Punith Kempegowda ◽

Anuradhaa Subramanian ◽

Joht Singh Chandan ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

Social Deprivation ◽

Population Based ◽

Incident Diabetes ◽

Lipid Lowering ◽

Diabetes Diagnosis ◽

Newly Diagnosed ◽

Foot Disease

Objective: To investigate the relationship between social deprivation and incident diabetes-related foot disease (DFD), in newly-diagnosed patients with type 2 diabetes. Research design and methods: A population-based, open retrospective cohort study, using The Health Improvement Network (01/01/2005-31/12/2019). Patients with type 2 diabetes, free of DFD at baseline, were stratified by Townsend deprivation index and the risk of developing DFD was calculated. DFD was defined as a composite of foot ulcer (FU), Charcot arthropathy, lower limb amputation (LLA), peripheral neuropathy (PN), peripheral vascular disease (PVD) and gangrene. Results: 176,359 patients were eligible (56% men; aged 62.9±13.1years). After excluding 26,094 patients with DFD before/within 15 months of type 2 diabetes diagnosis, DFD was incidentally developed in 12.1% of study population during 3.27years (IQR:1.41-5.96). Patients in the most deprived Townsend quintile had increased risk of DFD compared to those in the least deprived (aHR:1.22, 95%CI:1.16-1.29) after adjusting for sex, age at type 2 diabetes diagnosis, ethnicity, smoking, BMI, HbA1c, cardiovascular disease, hypertension, retinopathy, eGFR, insulin, glucose/lipid-lowering medications and baseline foot risk. Patients in the most deprived Townsend quintile had higher risk of PN (aHR:1.18, 95%CI:1.11-1.25), FU (aHR:1.44, 95%CI:1.17-1.77), PVD (aHR:1.40, 95%CI:1.28-1.53) LLA (aHR:1.75, 95%CI:1.08-2.83) and gangrene (aHR:8.49, 95% CI:1.01-71.58) compared to those in the least. Conclusion: Social deprivation is an independent risk factor for the development of DFD, PN, FU, PVD, LLA and gangrene in newly-diagnosed patients with type 2 diabetes. Considering the high individual and economic burden of DFD, strategies targeting patients in socially deprived areas are needed to reduce health inequalities.

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Diabetic foot self-care: awareness and practice among type 2 diabetic patients in primary healthcare centers, Dubai Health Authority

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20185221 ◽

2018 ◽

Vol 6 (1) ◽

pp. 1

Author(s):

Maira K. Mehmood ◽

Almas Z. Parkar ◽

Nayab T. Mustafa ◽

Sarah S. Mustafa ◽

Momina A. Makin ◽

...

Keyword(s):

Type 2 Diabetes ◽

Primary Healthcare ◽

Health Authority ◽

Diabetic Foot ◽

Self Care ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Cumulative Score ◽

Primary Healthcare Centers

Background: Diabetic foot disease is the most common complication of diabetes mellitus. With appropriate management, approximately 49-85% of diabetic foot complications can be prevented. This study was carried out due to lack of population-based studies on foot self-care in the U.A.E. The aim of this study is to assess the awareness and practice of foot self-care in patients with type 2 diabetes and study the factors affecting foot self-care.Methods: A cross-sectional study was conducted amongst patients of type-2 diabetes attending the diabetic clinics in primary healthcare centers under Dubai Health Authority. 488 participants were interviewed on a pre-tested structured questionnaire. The cumulative score of awareness and practice was classified into poor (<50 percentile), average (50-75 percentile) and good (>75 percentile).Results: 47% participants had an overall poor awareness and 46% had an overall poor practice of foot self-care. Compliance of medications to avoid complications had the highest awareness (83%) and practice (91%). Avoiding moisturizing between toes had the least awareness (40%) and practice (38%). Awareness was better in 59% of UAE nationals and 74% of postgraduates. Practice was better in 60% of males and 73% of participants with uncontrolled HbA1c. Participants who received prior information had better awareness (55%). Participants receiving information from Dubai Diabetes Centre (DDC) had better awareness (66%) and practice of foot self-care (66%).Conclusions: Almost half of the diabetic patients attending primary healthcare centers in Dubai have limited awareness and practice regarding diabetic foot self-care.

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