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@#Introduction: Diabetes is a chronic illness and it has a significant impact on health. Behavioral interventions theory could improve self-care practices of the foot among patients with diabetic. Behavioral interventions could prevent the risk of foot problems. This trial aims at determining the effect of patient education intervention on foot self-care behavior and clinical outcomes among diabetes patients. Methods: The study is a two-arm single-blinded randomized controlled trial which will be conducted in the Federal Medical Centre (FMC) Owerri, Imo state, Nigeria involving 160 diabetic patients. A central computer-generated randomization list will be generated. Sequentially numbered sealed opaque envelopes will be used to determine concealment. The sample size is 160; therefore 80 participants will receive three sessions of patient education in addition to usual care (intervention group) for three and six months while another 80 participants (control group) will receive only usual care and will receive health education after the study is completed. The outcome of the intervention effectiveness is measured by modified version of Diabetes foot Self-Care Behavior Scale (DFSBS). Discussion: Our hypothesis is that based on the Health Belief Model, patient education intervention can improve foot self-care behavior in the intervention group. Data collection will be done at baseline, and at three- and six-months post intervention. Trial Registration: The Clinical Trials Registry- India (CTRI), Reference no CTRI/2021/06/034311.
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@#Introduction: Diabetic foot ulcers (DFUs) remain one of the greatest significant problems of diabetes mellitus. It is a cause of main suffering and expenses for patient, and financial problem on health facilities and public. One of the strategies to overcome DFU is through health education to prevent foot ulcer, which focused in promoting foot self-care. To reach this aim, researchers had applied different educational approaches. This systematic review is to evaluate various types of educational programs in terms of its method of delivery and effectiveness. Methods: The search involved various databases; EBSCOHOST, MEDLINE, CINAHL, Cochrane library, ScienceDirect, PubMed, SAGE SringerLink, Web of Science and Wiley Online Library. It was limited to full text research articles that report intervention studies, and the writte up in English Language, the publication was from 2005 to 2021. The key words were “diabetes”, “diabetes foot”, “foot self-care”, health education and “interventions”. Results: Twenty studies were involved in this review. Nine studies were randomized controlled trials (RCTs), while eleven reported non-randomized controlled trials (NRCTs). Conclusion: There are evidences that foot care education improves foot care and diabetic foot problems. Various health education approaches, for instance foot assessment, discussion, counseling, homebased visitation and telephone calls have been shown to be effective in improving educational programs. Studies in the future should focus on RCTs in different sites and apply follow-up of long duration to provide better recommendations to healthcare practitioners on effective educational interventions to prevent DFUs.
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【Objective】 To explore the clinical effect of PRP on refractory ulcer of diabetes foot on the basis of routine treatment. 【Methods】 Sixty-four patients who suffered from diabetes foot and treated in our hospital from January to December 2020 were divided into the routine treatment group (44 cases) vs PRP plus routine treatment group (20 cases, using liquid or gel PRP for diversified treatment) according to a simple random sampling method. The general conditions of the two groups were evaluated to compare the wound surface, wound healing rate, treatment time, wound healing speed rate, adverse reactions and healing conditions after the treatment. 【Results】 The wound surface[0.05(0.00, 0.70)vs 0.35(0.00, 4.54)], wound healing rate[0.99(0.84, 1.00)vs 0.80(0.26, 1.00)] and wound healing speed rate[0.16(0.04, 0.27)vs 0.06(0.01, 0.18)] in PRP group were significantly higher than those in routine treatment group (P0.05), so was the adverse reactions to treatments[0(0/20)vs 2.27(1/44)](P>0.05). The response rate[100(20/20)vs 61.36(27/44)] of PRP group was significantly better than that of routine group, and the difference was statistically significant (P<0.05). 【Conclusion】 The therapeutic effect of PRP group was significantly superior to that of routine treatment group.
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@#Introduction: Diabetic foot ulcer is the main aetiology for non-traumatic amputation, which is a major public health care concern. A multidisciplinary approach in the management of this pathology has been shown to improve the surgical outcome. However, there are little data available on the tools we can use to pursue this multidisciplinary approach. The main goal of this cross-sectional study was to find out whether the implementation of a specific management pathway could improve the treatment outcome in the treatment of diabetic foot. Materials and Methods: From 2012 to 2014, we consecutively recruited patients with diabetic foot referred to Orthopaedic surgery department of our university for surgical opinion. A specific diabetic foot pathway was introduced in 2013. One group of patients who were treated with previous method were evaluated retrospectively. Another group of patients who were treated after implementation of the pathway were evaluated prospectively. We compared treatment outcome between the two groups. Results: We included 51 patients. Amputation rate was similar both the groups: 74% in the retrospective group not using the new pathway versus 73% in a prospective group that used the new pathway. Revision surgery was 39% in the retrospective group and 14% in the prospective group (p=0.05). Conclusion: We recommend the use of this simple and costeffective pathway to guide the interdisciplinary management of diabetic foot. A prospective study with more subjects would provide a better overview of this management pathway.
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Background: Diabetes has becoming an increasing cause of morbidity and mortality worldwide. Along with the rising prevalence of diabetes increase in the complications are expected which will further burden our health care services. Poor knowledge of foot care and poor foot care practices were identified as important risk factors for foot problems in diabetes.Methods: The present study was a mixed methods study conducted among diabetic patients attending medicine OPD. Quantitative data for foot care practices and peripheral neuropathy was collected from 190 diabetic patients and free listing among 20 diabetic patients was done to identify perceived barriers for foot care practices. Collected data were entered in Epi Info (3.5.3) and analysed using SPSS version 24 software.Results: The prevalence of peripheral neuropathy among the study participants was 52.9%. Significant association was found between peripheral neuropathy and male sex (p=0.006), occupation (p=0.003), smoking status (p=0.013) and longer duration of disease (p=0.04). The various reasons for poor foot care practices perceived by patients were poor knowledge about foot care, lack of knowledge about complications and health care provider did not teach them.Conclusions: The prevalence of peripheral neuropathy is common among diabetic patients and most of them are having poor foot care practices so there is a need in the community to lay emphasis on health education programs to improve foot care practices.
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@#Introduction: Diabetic foot infection, a complication which can lead to lower limb amputation, is a major source of morbidity and mortality in Malaysia. The objective of this study was to determine the predictive factors of major lower limb amputation among patients with diabetes mellitus in a cluster of three district hospitals in Pahang, Malaysia. Materials and Methods: This cross-sectional study involved 170 patients who had undergone surgical interventions for diabetic foot infections at three district hospitals from 1st of September 2014 to 31st December 2015. The predictors for major amputation of lower limb were determined using simple logistic regression (LR) and forward LR multiple logistic regression. Results: A total of 21 patients had undergone major amputations of lower limb (15 transtibial and 6 transfemoral). The following factors were associated with major amputation of lower limb; longer duration of disease, age ≥ 60 years, patients from Bentong Hospital, presence of hypertension, presence of fever, history of multiple limbsalvaging surgeries, monomicrobial culture, necrotising fasciitis, anemia and leukocytosis. Upon forward LR multiple logistic regression, only duration of disease, history of more than three previous limb-salvaging surgeries and total white blood cell count ≥15X109/L were found to be significant as predictive factors of major amputation of lower limb. Conclusion: Among the factors analysed in this study, a longer duration of disease, raised total white blood cell count and history of more than three limb-salvaging surgeries were identified as predictors for major amputation of lower limb in diabetic foot infections using stepwise logistic regression analysis.
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DM is the long term chronic disease that leads to late stage vascular complications and pathogeneses of chronic complication started 5-10 years ago when the diagnosed diabetes. T2DM can remain asymptomatic for many years, majority associated complications or several chronic diseases. Main risk for people with diabetes, that hyperglycemia in microvascular complications and alteration of dyslipidemia makes macro vascular complications such as foot amputation, disability, cardiovascular disease, kidney disease, blindness and stroke. Our study aimed to evaluate foot care patients of type 2 diabetes (T2DM) and determained risk factors for foot complication in newly diagnosed T2DM. The survey was conducted in Ulaanbaatar. For the study we 188 and 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self care for foot and self-management control. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software. The study involved mean age 20-69 years and male 43.1 %, female 56.9 % patients with T2DM who have been controlled by endocrinologists’ in hospitals s of Ulaanbaatar. Also we studied patients newly diagnosed T2DM mean age was 49.4±8.9 male 65(43.6%), female 85(56,7%) and 39.3% of the participants had a family history of diabetes.In last week self reported servey was in male 3.7 % every day foot care, 93.8 % of male without self care in foot, in female 48.5 % every day foot care (p0.05) in newly diagnosed T2DM. Participant’s bad glycemic control for diabetic foot risk factors are FBG, HbA1c,LDL were significantly higher than normal of health adults (p0.05). However, total cholesterol, HDL were normal level. From above results, the TG was statistically different between gender (p<0.05) Poor control in foot care by selt management in patients with newly diagnosed T2DM. Therefore poor glycemic and metabolic control in patients newly diagnosed T2DM.
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DM is the long term chronic disease that leads to late stage vascular complications and pathogeneses of chronic complication started 5-10 years ago when the diagnosed diabetes. T2DM can remain asymptomatic for many years, majority associated complications or several chronic diseases. Main risk for people with diabetes, that hyperglycemia in microvascular complications and alteration of dyslipidemia makes macro vascular complications such as foot amputation, disability, cardiovascular disease, kidney disease, blindness and stroke. Our study aimed to evaluate foot care patients of type 2 diabetes (T2DM) and determained risk factors for foot complication in newly diagnosed T2DM. The survey was conducted in Ulaanbaatar. For the study we 188 and 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self care for foot and self-management control. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software. The study involved mean age 20-69 years and male 43.1 %, female 56.9 % patients with T2DM who have been controlled by endocrinologists’ in hospitals s of Ulaanbaatar. Also we studied patients newly diagnosed T2DM mean age was 49.4±8.9 male 65(43.6%), female 85(56,7%) and 39.3% of the participants had a family history of diabetes.In last week self reported servey was in male 3.7 % every day foot care, 93.8 % of male without self care in foot, in female 48.5 % every day foot care (p0.05) in newly diagnosed T2DM. Participant’s bad glycemic control for diabetic foot risk factors are FBG, HbA1c,LDL were significantly higher than normal of health adults (p0.05). However, total cholesterol, HDL were normal level. From above results, the TG was statistically different between gender (p<0.05) Poor control in foot care by selt management in patients with newly diagnosed T2DM. Therefore poor glycemic and metabolic control in patients newly diagnosed T2DM.
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Objective To explore the prevalence of depression in diabetes foot ulcer patients , and to an-alyze the correlation between depression morbidity and various factors such as age , HbA1c level, and quality of life etc.Methods 73 diabetes foot ulcer patients admitted from Sep .2012 to Sep.2014 were enrolled.Depres-sion was assessed using the 9-item patient health questionnaire (PHQ-9).Data such as the age, sex, duration of diabetes and foot ulcer , HbA1C level, smoking were recorded .The severity of foot ulcer was evaluated by Wagner's classification.The quality of life was scored by short form(SF-36)health survey questionnaire.Results The morbidity of depression in diabetes foot ulcer patients was 49.3%in total and 17.8% in the moderate to severe depression group .The prevalence in patients with HbA 1c≥7.0%was significantly higher than that in pa-tients with HbA1c0.05).Conclusions This study shows a high prevalence of depression symptom in diabetes foot ulcer pa -tients.Depression is associated with HbA1c level, the extent and duration of foot ulcer .
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Objective:To observe the clinical treatment effects of Tangkang Xifang in the patients with type 0 diabetes foot ( DF) . Methods:Totally 73 patients with type 0 DF were randomly divided into the treatment group (n=37) and the control group (n=36). All the patients discontinued other medications for 7d before the treatment. Base on the blood glucose control with the traditional treat-ment by metformin hydrochloride (1. 5 g·d-1), the treatment group was additionally given warm water foot bath with Tangkang Xi-fang, while the control group was additionally given warm water foot bath, 30 min per time and twice a day for 60 days. The changes in the clinical symptoms, ankle brachial index ( ABI) , motor nerve conduction velocity ( MCV) and some other indices were measured before and after the treatment. Results:In comparison with the control group (58. 3%), the treatment group had higher total effective rate (86. 5%), and the usage of Tangkang Xifang also significantly improved the physiopathologic syndromes of peripheral artery dis-ease and neuropathy (P<0. 01). The ABI and MCV in the treatment group were significantly better than those in the control group (P<0. 05 or P<0. 01). Conclusion:Tangkang Xifang can effectively improve the clinical symptoms of type 0 DF, which is suitable for the clinical application.
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Objective To observe the efficacy of comprehensive strategies in treating diabetic foot.Methods Thirty five cases with diabetic foot were treated by comprehensive strategies,including antiinfection,strict blood sugar control,vasodilatation,improvement of microcirculation,never nutrition,debridement and supportive care,etc.Results Among the 35 patients with diabetic foot,24 were recovered satisfactorily,7 cases were recovered with improvement,2 cases underwent amputation and 2 cases gave up further treatment.Conclusion Diabetic foot can be treated by comprehensive measures satisfactorily,with improved cure rate and low amputation rate.
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ObjectiveTo investigate the curative effect of recombinant bovine basic fibroblast gnowth factor (rbbFGF)in the treatment of senile diabetic foot ulcer and summarize the nursing methods.Methods 28elderly patients with senile diabetic foot ulcer were divided into the control group and the treatment group with 14 patients in each group.The control group was given medical treatment and local wound dressing change,the treatment group was given rbbFGF based upon the above method.The degree of granulation tissue maturity,wound healing time and therapeutic effects were compared between these two groups.The nursing measures were summarized.ResultsOn the 9th day and 13th day,granulation tissue maturity degree of the treatment group was better than the control group.On the 14th day,21th day and 28th day,endepidermis growth velocity of the treatment group was better than the control group.The wound healing time of the treatment group was (29.87±5.73) d and was significantly shorter than (38.49±6.58) d of thecontrol group.The therapeutic effect of the treatment group was better than that of control group on the 28th day.ConclusionsApplication of rbbFGF has good curative effect on senile diabetic foot ulcer and suitable nursing care methods contributes to recovery of elderly patients.
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Objective: To observe the effect of ultrasound ablation combined with the balloon angioplasty in treatment of patients with arteriosclerosis obliteration of lower extremity and diabetic foot. Methods: The 60 limbs of 47 patients with arteriosclerosis obliteration of lower extremity (AOLE) were treated comprehensively by anti-infection,enlarging blood vessel, improving circulation,and anticoagulation; they also received ultrasound ablation,balloon angioplasty and stenting. Results: The patent rate of the 60 limbs was 93.3%. One month and 3 months after treatment with ultrasound ablation combined with balloon angioplasty,the MRI of artery of lower extremity,ultrasound manifestation,ankle-brachial index (ABI),the skin temperature of lower extremity and the sense to coolness,numbness,pain,ochrodermia or cyanosed were all improved to some extents compared with those before treatment. The healing of the diabetic foot was also accelerated. Conclusion: Ultrasound ablation combined with the balloon angioplasty and stenting, together with conventional treatment like anti-infection, anticoagulation, enlarging blood vessel, improving circulation, can reopen the occluded blood vessels and improve blood supply, thus provides a favourable condition for treatment of diabetic foot.
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Objective To investigate the correlation factor of diabetic foot ulcer in patients with type 2 diabetes.Methods To analyse the clinical manifestations and biochemical characteristics of patients with type 2 diabetes mellitus(diabetic foot ulcer 41,no foot ulcer 72).Results The cause of twenty patients was lack of the knowledge of foot care.Smoking and age were significantly correlated with diabetic foot(r=0.256,P