Foot Care for Patients With Diabetes

Use of Information Communication Technology Tools in Diabetic Foot Ulcer Prevention Programs: A Scoping Review

BACKGROUND

Information communication technology (ICT) tools are an integral part of day-to-day human activities. However, evidence of how ICT tools are used to engage individuals with diabetes to prevent diabetic foot ulcers (DFUs) is limited. In this review, we summarize the evidence on ICT tools used in DFU prevention programs and associated outcomes.

METHODS

We conducted a scoping review of the literature based on the Arksey and O'Malley methodologic framework. Four databases (MEDLINE, Embase, PsycINFO and CINAHL) were searched from 1960 to 2020 using keywords. Two reviewers independently screened the articles and performed data extraction and summarization.

RESULTS

Seventeen of 312 articles screened met the inclusion criteria and were included in the final analysis. Eleven ICT tools were utilized in 4 types of intervention: patient education, multidimensional foot health programs, remote temperature monitoring and pressure-sensitive insole systems. The identified ICT tools were used for presenting educational information, follow-up reinforcement of education, counselling, self-monitoring, remote patient monitoring by health-care professionals, self-care reminders, problem-solving, motivation and communication. In 59% of the studies, the interventions led to a significant reduction in recurrence of DFUs, improvement in self-care behaviour and cognition, and reduction of risk factors.

CONCLUSIONS

This review provides insight into a range of ICT tools used in DFU prevention programs. The findings suggest that interventions involving 1 or more ICT tools are often effective in improving diabetic foot care-related outcomes. Therefore, DFU prevention programs should include ICT tools among their components.

The Impact of Self Efficacy on the Foot Care Behavior of Type 2 Diabetes Mellitus Patients in Indonesia

Introduction: Diabetes mellitus (DM) often causes complications, one of which is diabetic foot ulcers (DFUs). One of the factors involved in preventing diabetic foot injuries is performing foot care behavior. To improve patient behavior in terms of performing foot care is to improve self-efficacy. The purpose of this study was to determine the effect of the self-efficacy of diabetes patients on foot care behavior.Methods: This study used a descriptive correlational design to reveal the correlative relationships between the variables with a sample of 106 respondents using probability sampling in the form of cluster random sampling. The data was collected using questionnaires, the foot care confidence scale (FCCS), and the foot care behavior scale for diabetes (FCBS for Diabetes). The independent variable of this study was the self-efficacy of DM sufferers and the dependent variable of this study was the behavior of foot care. The data analysis used the Spearman Rho correlation test (α=0.05).Results: Spearman Rho correlation test showed there to be a relationship between the self-efficacy of people with diabetes mellitus and foot care behavior p value = 0.001 (p<0.05), r= -0.542.Conclusion: The implication of this study is that a high self-efficacy in people with diabetes mellitus will improve the behavior related to foot care, thereby reducing the risk of behaviors that damage the feet.

Relationship of visual impairment and peripheral artery disease with the occurrence of diabetic foot ulcers in Dr. Moewardi Hospital

Objective

One of the diabetes mellitus (DM) complications is foot ulcers. Foot ulcers are influenced by many factors. DM puts patients at risk of injury because of visual impairment. Hyperglycemia can damage blood vessels, which results in peripheral artery disease (PAD). The purpose of this study was to find the relationship of visual impairment and PAD with diabetic foot ulcers.

Methods

This research used observational analytic study with case–control methods. It used purposive sampling in 34 DM patients with foot ulcers and 34 DM patients without foot ulcers. The research instruments were an interview guide to assess visual impairment, physical examination to assess PAD, and documentation study, which was used to know the incidence of diabetic ulcers.

Results

The results showed that the respondents who experienced ulcers with visual impairment were 44.1% and the respondents who had foot ulcers with PAD were 73.5%. The results of statistical tests showed that there was no relationship between visual impairment and the incidence of ulcers (P = 0.166). The respondents with PAD will have a chance to suffer from foot ulcers 5.808 times higher than those who do not have PAD.

Conclusions

There is no relationship between visual impairment and the incidence of diabetic foot ulcers in Dr. Moewardi Hospital, but there is relationship between PAD and the incidence of diabetic foot ulcers in Dr. Moewardi Hospital. Suggestions of this study are to do foot screening and educate about the importance of foot care to prevent the occurrence of diabetic ulcers.

Foot deformities within the diabetic foot and their influence on biomechanics: A review of the literature

BACKGROUND

Diabetes mellitus causes a multitude of complications. Foot ulceration is one complication with serious consequences, amputation. Foot deformities contribute to ulcer development. It would be advantageous to ascertain whether foot deformities are preventable as their presence increases amputation risk.

OBJECTIVES

The objectives were to understand the development of foot deformities in diabetes and explore their biomechanical effects.

STUDY DESIGN

Literature review.

METHODS

In February 2014 CINAHL, Embase, Ovid and Medline were searched. Studies in English of adults with Diabetes that reported neuropathy, foot deformities or associated gait abnormalities were included for review. All study designs were considered. The articles' quality was considered high overall, assessed using SIGN and CARS.

RESULTS

In total, 17 studies were reviewed. The main themes identified in relation to foot deformities were nerve function, intrinsic foot muscles, muscle weakness and limited joint mobility. Nerve function and intrinsic foot muscle atrophy did not display definitive associations with foot deformities. However, muscle weakness and limited joint mobility were associated with foot deformities, although the relationship is still unclear.

CONCLUSION

The development of common foot deformities in diabetes is not well understood. The literature did not support the common belief that motor neuropathy, atrophy and muscle imbalance cause foot deformities.

CLINICAL RELEVANCE

An understanding of the aetiology of foot deformities in diabetes mellitus may allow for pro-active management of the foot in anticipation of the development of foot deformities and ulceration. If the aetiology of deformity was established preventative treatment may reduce the incidence of foot deformities and resultant ulcerations and amputations.