scholarly journals Knowledge levels of individuals with type 2 diabetes on foot care

2020 ◽  
Vol 17 (2) ◽  
pp. 700-709
Author(s):  
Pınar Eroğlu ◽  
Birsen Yürügen

Purpose: In this study, is a descriptive designed to determine the level of knowledge about foot care of individuals with Type 2 diabetes mellitus. Materials and Method: Research consists 165 diabetic patient, (all of them over 40 years old) which admitted İstanbul University Cerrahpaşa Medical Faculty Endocrinology Metabolism Department. As a data collection tool, a questionnaire consisting of 44 questions which is prepared by the researcher was used. Results. The majority of the participants in the study are poorly educated, inactive and overweight participants in the 60-69 age group. Diabetic neuropathy was found in 44.8% and diabetic foot was found in 12.7% while at least one diabetic complication occurred in 65.5% of diabetic patients. 66.7% of the patient with diabetes had general diabetes education and 21.2% had diabetic foot training.  54.6% of this educations was given by the diabetes nurses.  The majority of the patient with diabetic chronic complications and foot injuries had received diabetes education. As the duration of diabetes increased, the incidence of complications increased. among these complications, retinopathy and cardiovascular diseases were more common in patients with diabetes over the 11 years. The proportion of foot injuries in elderly patients participating in the study is higher than other patients. Conclusion: As a result of the study, it was determined that the patients did not apply their foot care information, did not have foot care training as they need, they applied to the hospital after the problem developed, and only then they were educated. Diabetic individuals can be recommended for the planned education, adequate time for each subject, observation of the results of the trainings and repeated periodicals to overcome these deficiencies. ​Extended English summary is in the end of Full Text PDF (TURKISH) file.   Özet Amaç: Bu çalışma, tip 2 diyabet tanısı almış bireylerin ayak bakımı konusundaki bilgi düzeylerinin belirlenmesi amacıyla tanımlayıcı olarak yapılmıştır. Materyal ve Metot: Araştırma İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Endokrinoloji Metabolizma Bilim Dalı Diyabet servisine ve polikliniğine başvuran 40 yaş ve üzeri 165 tip 2 diyabetli hastadan oluşmaktadır. Veri toplama aracı olarak 44 sorudan oluşan ve araştırmacı tarafından hazırlanan bir anket formu kullanılmıştır. Bulgular: Çalışmaya katılan bireylerin çoğunluğu 60-69 yaş arası grupta, öğrenim düzeyi düşük, çalışmayan ve kilolu katılımcılardır. Diyabetlilerin %65.5’inde diyabete bağlı en az bir komplikasyon gelişirken %44.8’inde diyabetik nöropati ve %12.7’sinde diyabetik ayak tespit edilmiştir. Diyabetlilerin %66.7’si genel diyabet eğitimi, %21.2’si diyabetik ayak eğitimi almıştır.  Bu eğitimlerin %54.6’sı diyabet hemşiresi tarafından verilmiştir. Diyabete bağlı kronik komplikasyon ve ayak yarası gelişen diyabetlilerin çoğunluğu diyabet eğitimi almıştı. Diyabet süresi artıkça komplikasyon görülme oranı da artmaktaydı. Bu komplikasyonlardan retinopati ile kardiyovasküler hastalıklar 11 yıl üzeri diyabetlilerde daha yüksektir. Çalışmaya katılan yaşlı hastalardaki ayak yarası oranı, diğer hastalardan daha fazladır. Sonuç: Çalışmanın sonucunda hastaların ayak bakımı konusundaki bilgilerini uygulamaya geçirmedikleri, yeteri kadar ayak bakımı eğitimi almadıkları, sorun geliştikten sonra hastaneye başvurdukları ve ancak o zaman eğitim aldıkları belirlendi. Diyabetli bireylere verilen eğitimlerin planlı olması, her konuya yeterli zaman ayrılması, eğitimlerin sonuçlarının gözlemlenmesi ve belirli aralıklarla tekrarlanması bu eksikliklerin giderilmesi için önerilebilir.

2021 ◽  
Vol 24 (1) ◽  
pp. 32-44
Author(s):  
T. A. Zelenina ◽  
V. V. Salukhov ◽  
A. B. Zemlianoi ◽  
S. G. Zheleznjak ◽  
O. A. Klitsenko

BACKGROUND: Diabetic autonomic neuropathy is the reason for early morbidity and mortality on diabetic patients. The pathology not only cardiac innervation but microvascular is presented.AIMS: We estimated the parameters of skin microvascular blood flow in accordance with cardiovascular autonomic neuropathy (CAN) staging in diabetic patients. We also assessed other risk factors of CAN in patients with diabetes.MATERIALS AND METHODS: We included 76 patients with type 2 diabetes in the study (24 patients with resent-onset diabetes and/or diabetes without microvascular complications, 26 with diabetic sensorimotor neuropathy (SMN) and 26 with SMN and previous history of diabetic foot amputation). The SMN was diagnosed on the basis of patients complaints, anamnesis and data of clinical neurological examinations. CAN was detected using several cardiovascular autonomic reflex tests (CART) as a gold standard of diagnosis: the tilt-table test, a deepbreathing and Valsalva Maneuver, handgrip test, cold-stress vasoconstriction. According to the Toronto Diabetic Neuropathy Expert Group Recommendation all patients was separated on the groups: CAN 0 (all CARTs were normal), CAN 1 (possible/early CAN — one abnormal CART was presented), CAN 2 (definite/confirmed CAN –at least two abnormal CARTs were found), CAN 3 (severe/advanced CAN — in the cases of orthostatic hypotension in addition to CARTs abnormalities). Microvascular blood flow of skin at the nail roller of fingers skin was valuated at rest as well as in functional cold test by the method of High-frequency Ultrasonic Dopplerography using the “Minimax Doppler K” device (LLC JV “Minimax”, St. Petersburg, Russia).RESULTS: CAN 1 was found in 8% diabetic patients without microvascular complications, 42 and 21% patients with SMN and diabetic foot amputations respectively. CAN 2 was diagnosed in 27% patients with SMN and 58% patients history of diabetic foot amputations. CAN 3 in 8% and 19% cases in patients with SMN and history of diabetic foot amputations respectively. The parameters of microvascular blood flow at rest were significantly decreased in patients with confirmed/severe CAN in comparison with early staging of CAN and patients without CAN (Vm=2.5±0.66 sm/sec vs. 4.4±0.54 sm/sec and 5.1±1.01 sm/sec respectively; p=0.0033). The abnormal result of cold test was detected in 94% patients with confirmed/ severe CAN and 26% patients with CAN 1.CONCLUSIONS: This investigation has demonstrated in a cohort with type 2 diabetes patients with/without SMN and with/ without history of previously foot amputations that decrease the Vm (the variable of microvascular blood flow assessed by High-frequency Ultrasonic Dopplerography) lower than 2.4 sm/sec is associated with 6.4 times increased likelihood of confirmed/severe CAN as well as positive cold test result. That the patients with positive cold test results were 28.6 times more likely have confirmed/severe CAN.


2018 ◽  
Vol 1 (1) ◽  
pp. 124-131
Author(s):  
Rina Amelia

Diabetes merupakan peyakit kronis yang disebabkan karena kekurangan atau tidak efektifnya insulin yang dihasilkan. WHO memperkirakan jumlah penduduk dunia yang menderita diabetes pada tahun 2030 akan meningkat paling sedikit menjadi 366 juta. Indonesia menempati urutan keempat terbanyak dengan prevalensi 8,6% dari seluruh penduduk. Diabetes akan menjadi masalah yang serius apabila telah terjadi komplikasi, salah satu komplikasi adalah luka kaki diabetes (diabetic foot). Komplikasi luka kaki diabetes menjadi penyebab lamanya hospitalisasi dan amputasi lebih dari 90% ekstremitas bawah pada penderita diabetes. Tujuan penelitian adalah untuk menganalisis hubungan perilakuperawatan kaki dengan terjadinya komplikasi luka kaki diabetes pada pasienDM tipe 2di Puskesmas Tuntungan Medan. Disain penelitian adalah analitik dengan pendekatan cross sectional. Populasi penelitian adalah seluruh penderita DM tipe 2 yang datang ke Puskesmas Tuntungan Medan dengan sampel sebanyak 83 orang (consecutive sampling). Instrumen penilaian perilaku perawatan kaki yang digunakan adalah Questions determining the knowledge and practice about foot careyang terdiri dari 15 item pertanyaan. Analisis data menggunakan uji statistik chi square. Hasil penelitian menunjukkansebanyak 48 orang pasien diabetes (57,8%) memiliki perilaku yang buruk terhadap perawatan kaki, sebanyak 29 orang (349%) mempunyai riwayat komplikasi luka kaki dibetes (ulkus). Hasil analisis chi square menunjukkan terdapat hubungan antara perilaku perawatan kaki diabetes dengan kejadian komplikasi luka kaki diabetes pada pasien DM tipe 2 di Puskesmas Tuntungan Medan (p<0.05). Perilaku perawatan kaki sangat berperan terhadap terjadinya luka kaki diabetes. Untuk membentuk perilaku yang baik dibutuhkan edukasi oleh dokter maupun oleh petugas kesehatan kepada pasien diabetes. Diabetes is a chronic disease caused by lack or ineffectiveness of insulin. WHO estimates that the world population with diabetes in 2030 will increase to at least 366 million people. Indonesia is the world’s fourth most populated country and its prevalence of diabetes is 8.6% of the entire population. Diabetes will be a serious problem once complications occurrs. One of the complications is diabetic foot.  diabetic foot  caused a longer length of hospital stay and more than 90% leads to the amputation of the lower limb . The objective of this study was to analyze the relationship between diabetic foot care behaviors and the diabetic foot complications in patients with type 2 diabetes mellitus at Tuntungan Public Health Center in Medan. This study employed an analytic study  with cross sectional approach. The population of this study was all patients with type 2 diabetes mellitus who came to Tuntungan Public Health Center in Medan  and 83 patients were recruited as samples (consecutive sampling). The research used a questionnaires with 15 questions   to collect data of knowledge and foot care behaviour. Data were analyzed using chi square test. The results showed that 48 diabetic patients (57.8%) demonstrated poor behavior towards foot care, 29 patients (349%) had a history of diabetic foot ulcer complications. The results of the chi square analysis showed that there was a significant relationship between diabetic foot care behavior and diabetic foot complications in patients with type 2 Diabetes Mellitus at Tuntungan Public Health Center in Medan (p <0.05). It was concluded that foot care behavior had a high correlation with the incidence of diabetic foot. It is recommended that doctors and health staffs educate diabetic patients to perform good foot care behaviors.


Author(s):  
Maira K. Mehmood ◽  
Almas Z. Parkar ◽  
Nayab T. Mustafa ◽  
Sarah S. Mustafa ◽  
Momina A. Makin ◽  
...  

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.


Biomolecules ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 96 ◽  
Author(s):  
Duygu Sak ◽  
Fusun Erdenen ◽  
Cuneyt Müderrisoglu ◽  
Esma Altunoglu ◽  
Volkan Sozer ◽  
...  

Background: Taurine has an active role in providing glucose homeostasis and diabetes causes a decline in taurine levels. This paper investigates the relationship between taurine and diabetic complications, patients’ demographic features, and biochemical parameters. Methods: Fifty-nine patients with type 2 diabetes mellitus (T2DM), and 28 healthy control subjects between the ages of 32 and 82 were included in the study. The mean age of subjects was 55.6 ± 10.3 and mean diabetes duration was 10.2 ± 6.0 years. The most commonly accompanying comorbidity was hypertension (HT) (64.5%, n = 38), and the most frequent diabetic complication was neuropathy (50.8%, n = 30). Plasma taurine concentrations were measured by an enzyme-linked immunoassay (ELISA) kit. Results: Plasma taurine concentrations were significantly lower in diabetic patients (0.6 ± 0.1 mmol/L) than controls (0.8 ± 0.2 mmol/L) and in hypertensive (0. 6 ± 0.1 mmol/L) patients (p = 0.000, p = 0.027 respectively). Conclusion: Plasma taurine levels were decreased in patients with T2DM and this was not related to FBG, HbA1c, and microalbuminuria. With regard to complications, we only found a correlation with neuropathy. We suggest that taurine levels may be more important in the development of diabetes; however, it may also have importance for the progression of the disease and the subsequent complications. We further assert that taurine measurement at different times may highlight whether there is a causal relationship in the development of complications.


2020 ◽  
Vol 13 ◽  
pp. 117955142098190
Author(s):  
Girma Degefa ◽  
Kindie Wubshet ◽  
Sisay Tesfaye ◽  
Agete Tadewos Hirigo

Background: Adequate knowledge, awareness, and adherence to diabetic self-care practices are vital tools to protect patients from risks of disease complications, developing comorbidity and mortality. Therefore, this study aimed to assess specific domains of diabetic self-care practice and associated factors among patients with type-2diabetes in Hawassa University Comprehensive Specialized Hospital, Sidama regional state. Materials and methods: A hospital-based cross-sectional study design was conducted on 217 patients with type 2 diabetes from January 01 to April 30, 2020. A structured questionnaire and the Summary of Diabetes Self-Care Activities (SDSCA) tool were used to collect relevant data through interviewer administration. Statistical analysis was done using SPSS version 23. Results: A total of 207 patients with type-2 diabetes were participated in the study with a 95% response rate. Overall 47.8% (95%CI: 41.2-55) of patients adhered to diabetic self-care practice. Concerning the specific domain of self-care practice, 54.6%, 39.1%, 28%, and 65.2% of patients adhered to a healthy diet, physical exercise, self-monitoring blood glucose (SMBG), and diabetic foot care practices, respectively. Besides, all patients received at least 80% of the prescribed doses and frequency of anti-diabetic agents and 60.4% had good glycemic control. Receipt of advice from treating physicians and having no familial history of diabetes were significantly associated with adherence toward eating a healthy diet, diabetic foot care, and SMBG. While male sex was associated with adherence toward healthy diet management. Moreover, having glucometer, age, male sex, diabetes duration ⩾ 5 years, and anti-diabetic treatment modality were associated with adherence toward SMBG. Conclusion: This study indicates 52.2%, 72%, and 60.1% of diabetes patients did not adhere to diabetic self-care, SMBG, and physical exercise, respectively. Improving awareness and regular diabetic education is imperative to scale up patients’ adherence toward diabetic self-care practice.


2018 ◽  
Vol 1 (1) ◽  
pp. 1-5
Author(s):  
Alfi Dewi Sholat ◽  
Dairion Gatot ◽  
Savina Handayani ◽  
Andri Iskandar Mardia ◽  
Santi Syafril

In type 2 diabetes mellitus, there are changes in hemostasis components, including overexpression of PAI-1. By these facts, the authors are interested in conducting the study of PAI-1 level in diabetic patients with and without foot ulcer. Methods: The sample of this research was collected cross-sectionally on 20 type 2 diabetic patients with foot ulcer and 20 without foot ulcer. Blood samples were taken to measure serum PAI-1 level, complete blood count and hemostasis screening test. Results: Statistical analysis showed there are significant differences in hemoglobin, trombosit, Fibrinogen and D-dimer levels in the ulcer and non-ulcer groups but no significant difference in PAI-1 level. Conclusions: No higher PAI – 1 level were found in diabetic foot ulcer group than those without diabetic foot ulcer. There was no significant difference between PAI-1 level and grade of diabetic foot ulcer.


2020 ◽  
Vol 7 (5) ◽  
pp. 754
Author(s):  
Damanpreet Singh ◽  
Gurinder Mohan ◽  
Arshdeep Bansal

Background: Hypothyroidism is an endocrine disorder resulting from deficiency of thyroid hormones, and Diabetes is a metabolic disorder that share the phenotype of hyperglycaemia. Both the endocrinopathies have been found to be associated with dyslipidaemia and atherosclerosis that result into various complications. Our aim was to assess the difference of dyslipidaemia in patients suffering from hypothyroidism with diabetes as compared to diabetes alone.Methods: Study was conducted in department of medicine in SGRDIMSR, Sri Amritsar. A total of 120 patients were enrolled for the present study, the one who presented to hospital from January 2018 to August 2019 diagnosed with diabetes mellitus type 2. The patients were divided into two groups. 60 patients having type 2 diabetes without hypothyroidism (control group). 60 patients having type 2 diabetes with hypothyroidism (study group). Fasting lipid profile were performed in both the groups and were analysed for the study.Results: Dyslipidaemia was seen more in study group as compared to control group with mean cholesterol of 488.3(±144.43) and mean triglyceride levels of 354.30(±128.57) in study  group as compared to control group with mean cholesterol and triglyceride levels of 179.7(±81.47) and 177.08(±118.18) with p-value of 0.001 and 0.01 respectively which were significant. Also, obesity and diabetic complication were more in patients of dual endocrinopathies as compared to diabetes alone which were also significant statistically.Conclusions: From our study it is concluded that type 2 diabetes with hypothyroidism causes more dyslipidaemia as compare to type 2 diabetes alone. So proper screening of thyroid profile of type 2 diabetic patients and its correction helps in achieving better lipidemic control which further prevent complications.


Author(s):  
Mohd Riyaz Beg ◽  
Vidhi Gupta

Diabetic foot ulcerations have been extensively reported as vascular complications of diabetes mellitus associated with a high degree of morbidity and mortality; in fact, some studies showed a higher prevalence of major, previous and new-onset, cardiovascular, and cerebrovascular events in diabetic patients with foot ulcers than in those without these complications. This is consistent with the fact that in diabetes there is a complex interplay of several variables with inflammatory metabolic disorders and their effect on the cardiovascular system that could explain previous reports of high morbidity and mortality rates in diabetic patients with amputations. Involvement of inflammatory markers such as IL-6 plasma levels in diabetic subjects confirmed the pathogenetic issue of the “adipovascular” axis that may contribute to cardiovascular risk in patients with type 2 diabetes. In patients with diabetic foot, this “adipovascular axis” expression in lower plasma levels of adiponectin and higher plasma levels of IL-6 could be linked to foot ulcers pathogenesis by microvascular and inflammatory mechanisms. The purpose of this review is to focus on the immune inflammatory features of DFS and its possible role as a marker of cardiovascular risk in type 2 diabetes patients.


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