ABSTRACT
Introduction: Diabetic dermopathy (DD) is the most common cutaneous diabetes marker. Few studies have targeted DD using low-level laser therapy (LLLT). This pilot study aimed to evaluate the effect of LLLT on DD in patients with type 2 diabetes (T2D). Methods: 12 patients with T2D (9 men, 3 women) and bilateral DD were enrolled in this placebo controlled pilot study, and their ages ranged 50-65 years. One side was subjected to LLLT, three sessions weekly for one month (LLLT side), while the other side received the same treatment protocol with a laser device switched off as a placebo (placebo side). All patients were instructed to receive skincare for both sides, such as debridement, antibiotic creams, and dressings with betadine solution. The diameter of DD lesion and the cutaneous blood flow of the knees and ankles sites were assessed before and after one month at the end of the intervention. Results: At the baseline, no significant differences existed between LLLT and placebo sides in the DD and skin blood flow at the knee and ankle sites (P >0.05). Post-intervention, a significant improvement occurred in DD diameter and the skin blood flow of the knee and ankle sites in the LLLT side (P <0.05), while the placebo side showed a significant improvement only in DD diameter (P <0.05) and non-significant changes in skin blood flow (P >0.05). Comparing both sides, all measures significantly favored LLLT. Conclusion: The findings of this study indicate that LLLT has beneficial effects on decreasing DD in T2D patients. Also, it was approved that the short term of LLLT is a safe modality to control DD in T2D patients.
ABSTRACT
BACKGROUND: Frailty status among Saudi adults is unknown due to the lack of a reliable and validated Arabic instrument that can be applied directly to the Saudi population. OBJECTIVE: Cross-culturally adapt and validate the Arabic version of the FRAIL scale in community-dwelling older adults. DESIGN: Cross-sectional. SETTINGS: The outpatient clinic of a tertiary care hospital. SUBJECTS AND METHODS: People aged ≥65 years who attended the outpatient clinic were recruited to participate. The original FRAIL scale was translated into Arabic and psychometric properties were examined for each item on the FRAIL scale and the total score, test-retest reliability over two visits with a one-week interval. We assessed criterion-related validity with the Fried Frailty Index as a reference measure and construct validity with other related measurements. MAIN OUTCOME MEASURES: Arabic version of the FRAIL Scale, grip strength, the Mini-Mental State Examination, a short physical performance battery, the Timed Up and Go test, the Fried Frailty Index, and the Duke Comorbidity Index. SAMPLE SIZE AND CHARACTERISTICS: 47 community-dwelling older adults (66% male, mean [SD] age 70 [4] years). RESULTS: The Arabic version of the FRAIL scale showed acceptable internal consistency (Cronbach's alpha=0.786) and good test-retest reliability within a one-week interval (intraclass correlation coefficient=0.77). Statistically significant correlations were found between the Arabic FRAIL scale, the Fried Frailty Index, and other frailty related measurements such as the Mini-Mental State Examination, the Duke comorbidity index, the Short Physical Performance Battery, and the Timed Up And Go Test. Using the Fried Frailty Index as the criterion measure, the Arabic FRAIL scale demonstrated good diagnostic accuracy for frailty (AUC=0.71). The optimal cutoff point for frailty on the Arabic FRAIL scale was 3, which yielded a sensitivity of 72% and specificity of 67%. The prevalence of frailty varied according to the FRAIL-AR (37%) and the Fried Frailty Index (28%). CONCLUSIONS: The FRAIL scale was successfully translated and culturally-adapted to Saudi older adults. The adapted Arabic version demonstrated acceptable internal consistency, test-retest reliability, and validity. Further study is needed to establish the validity of FRAIL-AR scale in a larger cohort in Saudi Arabia LIMITATIONS: The small sample size and single geographic area may affect the generalizability of the results across the country. CONFLICT OF INTEREST: None.
