Prevalence of diabetic peripheral neuropathy in patients with type 2 diabetes mellitus at a tertiary referral centre in Singapore

Background: There is a lack of data regarding prevalence estimates of diabetic peripheral neuropathy (DPN) in Singapore. This study aimed to investigate the prevalence of DPN and risk factors in patients who present to a diabetic foot screening clinic and are considered low to medium risk in developing foot complications due to their type 2 diabetes mellitus. Methods: A one-year retrospective analysis was conducted at Ng Teng Fong General Hospital. Patients who underwent diabetic foot screening and endocrinologist review in the Diabetes and Endocrinology Specialist Outpatient Clinic during the period January 2019–December 2019 were included in this study. DPN was defined by the patient’s inability to detect ⩾1 out of 10 sites using the 10 g monofilament. Significantly associated risk factors with DPN were analysed using a multivariable logistic regression model. Results: Data from 479 patients were analysed. Prevalence of DPN was 28% (95% confidence interval (CI) 24.0–32.2). DPN was significantly associated with age >65 years (odds ratio (OR)=5.44, 95% CI 2.87–10.32), Indian ethnicity (OR=1.99, 95% CI 1.04–3.80), insulin use (OR=1.65, 95% CI 1.03– 2.64), diabetic retinopathy (OR=2.36, 95% CI 1.47–3.78) and stroke (OR=2.44, 95% CI 1.03–5.77). Conclusion: Prevalence of DPN in this study’s population sample was 28%, and the significant risk factors are age, Indian ethnicity, insulin use, diabetic retinopathy and stroke.

SKRINING KAKI DIABTES UNTUK DETEKSI DINI LUKA KAKI DIABETES PADA PASIEN DIABETES

Latar Belakang: Prognosis LKD yang tidak dirawat dengan baik akan berdampak buruk yaitu amputasi bahkan kematian sehingga dibutuhkan tindakan pencegahan yaitu skrining kaki diabetes. Tujuan dari review ini, untuk mengetahui metode skrining kaki diabetes untuk mencegah terjadi luka kaki diabetes (LKD). Metode database yang digunakan pada pencarian artikel yaitu pubmed, wiley dan science direct. Hasil: kata kunci yang digunakan diabetic foot screening OR diabetes foot screening jumlah artikel yang didapatkan 39 artikel dari tiga database dan artikel yang menjadi kriteria inklusi artikel, artikel tahun 2013-2018, merupakan hasil penelitian, sesuai tema scoping review dan artikel full text, sehingga terdapat empat artikel yang terinklusi. Dari artikel tersebut dua artikel yang membahas metode skrining kaki diabetes untuk mendeteksi neuropati dan dua artikel yang membahas metode skrining kaki diabetes untuk mendeteksi angiopati. Skrining kaki diabetes untuk mendeteksi neuropati dapat menggunakan metode sudoscan yang dapat mendeteksi 34% tidak ada neuropati, tanpa gejala 69% dan dengan gejala 61,7%. Metode Ipswich touch test (IpTT) dapat digunakan oleh tenaga non professional di rumah dan klinik dalam mendeteksi neuropati dengan sensitivitas 78,3% dan 81,2%, spesifitas 93,9% dan 96,4%. Metode dalam mendeteksi angiopati adalah ankle brachialis index (ABI). Kombinasi hasil palpasi nadi yang lemah /hilang dan ABI yang abnormal menghasilkan sensitivitas dan nilai prediksi negatif tertinggi (92,3 % dan 89,8%) penyebab peripheral arterial disease (PAD). Kesimpulan: metode skrining kaki diabetes untuk mendeteksi neuropati terdiri atas beberapa metode yang aman untuk digunakan. ABI dapat digunakan mendeteksi PAD. Key word: skrining kaki diabetes, neuropati, angiopati

Strategies to Improve Annual Diabetic Foot Screening Compliance at a Family Clinic

The project site is a primary care practice in Southeast Texas that provides efficient and easily accessible preventive care to patients of all ages and demographics. Given that Texas has the highest uninsured rate in the United States, this clinic also prides itself on offering affordable options for self-pay patients. The clinic is staffed by two providers, an office manager, two medical assistants, a biller, and a front desk clerical staff member. This family clinic is unique in that it serves as a teaching clinic for medical, nurse practitioner, and physician assistant students. Healthcare professional trainees are directly supervised by licensed providers during their learning experience. The clinic treats ~2,000 patients annually, 156 of which have been diagnosed with diabetes. Of those with diagnosed diabetes, 70% are >50 years of age.

Strategies to Improve Annual Diabetic Foot Screening Compliance at a Family Clinic

The project site is a primary care practice in Southeast Texas that provides efficient and easily accessible preventive care to patients of all ages and demographics. Given that Texas has the highest uninsured rate in the United States, this clinic also prides itself on offering affordable options for self-pay patients. The clinic is staffed by two providers, an office manager, two medical assistants, a biller, and a front desk clerical staff member. This family clinic is unique in that it serves as a teaching clinic for medical, nurse practitioner, and physician assistant students. Healthcare professional trainees are directly supervised by licensed providers during their learning experience. The clinic treats ~2,000 patients annually, 156 of which have been diagnosed with diabetes. Of those with diagnosed diabetes, 70% are >50 years of age.

MANAJEMEN ULKUS KAKI DIABETIKUM : EFEKTIFITAS FOOT EXERCISE TERHADAP RISIKO DFU (DIABETIC FOOT ULCERS) PASIEN DIABETES MELLITUS DI AL HIJRAH WOUND CARE CENTER

ABSTRAK Jumlah penderita DM (diabetes melitus) saat ini semakin meningkat. Salah satu komplikasi yang terjadi yaitu DFU (diabetic foot ulcers). Banyak cara yang dapat dilakukan untuk mencegah DFU, salah satunya dengan diabetic foot exercise. Penelitian ini bertujuan untuk mengetahui efektifitas diabetic foot exercise terhadap risiko dfu (diabetic foot ulcers) pasien diabetes mellitus. Penelitian menggunakan design pre-eksperimen dengan pendekatan one-group pra-post test design. Populasi penderita diabetes yang berjumlah 60 orang, besar sampel 40 orang yang diambil menggunakan teknik purposive sampling. Resiko DFU dinilai menggunakan inlow’s 60-second diabetic foot screening tool dengan metode observasi. Analisa data menggunakan uji statistik Wilcoxon. Hasil penelitian ini didapatkan bahwa sebelum dilakukan diabetic foot exercise sebagian besar reponden mempunyai risiko sedang sebanyak 30 orang (75%), sesudah dilakukan diabetic foot exercise diperoleh bahwa sebagian besar responden risiko rendah sebanyak 32 orang (80%). Uji statistik Wilcoxon diperoleh nilai p value = 0,001 dimana nilai p value<α (0,05) yang berarti ada pengaruh diabetic foot exercise terhadap risiko diabetic foot ulcers. Diabetes foot exercise sangat efektif untuk penderita diabetes dalam mencegah risiko DFU. Penderita diabetes dapat melakukan diabetic foot exercise 2 kali dalam seminggu secara teratur. Kata Kunci : Diabetes mellitus, Diabetic foot ulcers, diabetic foot exercise

Reliability and credibility analysis of Inlow’s 60 second diabetic foot screening tool for diabetic foot risk stratification and its feasibility in India: a systematic review

Diabetes is the common cause for amputation of lower limb. Foot ulcers and associated complications are important causes of mortality and morbidity in patients with diabetes. Hence, it is important to predict diabetic foot ulcer in its early stages to eliminate the risks of foot amputation. Inlow’s 60 second diabetic foot ulcer screening tool is gaining immense attention over the years which is associated with its simplicity to use, rapid detection of high risk diabetic feet, and provides referral for patients necessitating treatment. A systematic review is conducted to assess the reliability and credibility of using Inlow’s 60 second diabetic foot screening tool for diabetic foot risk stratification and to examine its feasibility in the Indian context. Eight studies suited the inclusion criteria which were analysed systematically. The findings of the paper reveal that the sixty second tool acts as a better tool for diabetic foot ulcer risk stratification; however, modifications are necessary for its application in the Indian context.