Is There a Role for Informal Caregivers in the Management of Diabetic Foot Ulcers? A Narrative Review

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Successful management of diabetic foot ulceration (DFU) is crucial for preventing long-term morbidity and lowering risk of amputations. This can be achieved with a multifaceted approach involving a multidisciplinary team, with the patient at the centre. However, not all healthcare setups enable this, and the rate of lower limb amputations continues to rise. It is therefore time to consider new approaches to diabetic foot care, capitalising on engagement from patients in self-management while supported by their informal caregivers (ICGs) to help improve outcome. The role of ICGs in DFU care has the potential to make a significant difference in outcome, yet this resource remains, in most cases, underutilised. Limited research has been conducted in this area to reveal the true impact on patient outcomes and the caregivers themselves. This narrative review aims to explore how ICGs can benefit DFU management with applicability to different healthcare setups while benefiting from established experience in the care of other chronic health conditions.

Related collections

Most cited references 45

Record: found
Abstract: not found
Article: not found

IWGDF guidance on the diagnosis and management of foot infections in persons with diabetes.

Benjamin A Lipsky, Javier Aragón-Sánchez, Mathew A. Diggle … (2016)

0 comments Cited 163 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Diabetic Foot Complications and Their Risk Factors from a Large Retrospective Cohort Study

Khalid Al-Rubeaan, Mohammad Al Derwish, Samir Ouizi … (2015)

Background Foot complications are considered to be a serious consequence of diabetes mellitus, posing a major medical and economical threat. Identifying the extent of this problem and its risk factors will enable health providers to set up better prevention programs. Saudi National Diabetes Registry (SNDR), being a large database source, would be the best tool to evaluate this problem. Methods This is a cross-sectional study of a cohort of 62,681 patients aged ≥25 years from SNDR database, selected for studying foot complications associated with diabetes and related risk factors. Results The overall prevalence of diabetic foot complications was 3.3% with 95% confidence interval (95% CI) of (3.16%–3.44%), whilst the prevalences of foot ulcer, gangrene, and amputations were 2.05% (1.94%–2.16%), 0.19% (0.16%–0.22%), and 1.06% (0.98%–1.14%), respectively. The prevalence of foot complications increased with age and diabetes duration predominantly amongst the male patients. Diabetic foot is more commonly seen among type 2 patients, although it is more prevalent among type 1 diabetic patients. The Univariate analysis showed Charcot joints, peripheral vascular disease (PVD), neuropathy, diabetes duration ≥10 years, insulin use, retinopathy, nephropathy, age ≥45 years, cerebral vascular disease (CVD), poor glycemic control, coronary artery disease (CAD), male gender, smoking, and hypertension to be significant risk factors with odds ratio and 95% CI at 42.53 (18.16–99.62), 14.47 (8.99–23.31), 12.06 (10.54–13.80), 7.22 (6.10–8.55), 4.69 (4.28–5.14), 4.45 (4.05–4.89), 2.88 (2.43–3.40), 2.81 (2.31–3.43), 2.24 (1.98–2.45), 2.02 (1.84–2.22), 1.54 (1.29–1.83), and 1.51 (1.38–1.65), respectively. Conclusions Risk factors for diabetic foot complications are highly prevalent; they have put these complications at a higher rate and warrant primary and secondary prevention programs to minimize morbidity and mortality in addition to economic impact of the complications. Other measurements, such as decompression of lower extremity nerves, should be considered among diabetic patients.

0 comments Cited 135 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Causal pathways for incident lower-extremity ulcers in patients with diabetes from two settings.

E Boyko, G Reiber, Edward Boyko … (1998)

To determine the frequency and constellations of anatomic, pathophysiologic, and environmental factors involved in the development of incident diabetic foot ulcers in patients with diabetes and no history of foot ulcers from Manchester, U.K., and Seattle, Washington, research settings. The Rothman model of causation was applied to the diabetic foot ulcer condition. The presence of structural deformities, peripheral neuropathy, ischemia, infection, edema, and callus formation was determined for diabetic individuals with incident foot ulcers in Manchester and Seattle. Demographic, health, diabetes, and ulcer data were ascertained for each patient. A multidisciplinary group of foot specialists blinded to patient identity independently reviewed detailed abstracts to determine component and sufficient causes present and contributing to the development of each patient's foot ulcer. A modified Delphi process assisted the group in reaching consensus on component causes for each patient. Estimates of the proportion of ulcers that could be ascribed to each component cause were computed. From among 92 study patients from Manchester and 56 from Seattle, 32 unique causal pathways were identified. A critical triad (neuropathy, minor foot trauma, foot deformity) was present in > 63% of patient's causal pathways to foot ulcers. The components edema and ischemia contributed to the development of 37 and 35% of foot ulcers, respectively. Callus formation was associated with ulcer development in 30% of the pathways. Two unitary causes of ulcer were identified, with trauma and edema accounting for 6 and < 1% of ulcers, respectively. The majority of the lesions were on the plantar toes, forefoot, and midfoot. The most frequent component causes for lower-extremity ulcers were trauma, neuropathy, and deformity, which were present in a majority of patients. Clinicians are encouraged to use proven strategies to prevent and decrease the impact of modifiable conditions leading to foot ulcers in patients with diabetes.

0 comments Cited 119 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Ali M. Aldibbiat:

ORCID: http://orcid.org/0000-0002-1493-4571

ali.aldibbiat@dasmaninstitute.org

Journal

Journal ID (nlm-ta): Diabetes Ther

Journal ID (iso-abbrev): Diabetes Ther

Title: Diabetes Therapy

Publisher: Springer Healthcare (Cheshire )

ISSN (Print): 1869-6953

ISSN (Electronic): 1869-6961

Publication date (Electronic): 26 September 2019

Publication date PMC-release: 26 September 2019

Publication date (Print): December 2019

Volume: 10

Issue: 6

Pages: 2025-2033

Affiliations

[1 ]GRID grid.452356.3, ISNI 0000 0004 0518 1285, Podiatry Department, , Dasman Diabetes Institute, ; Dasman, Kuwait City, Kuwait

[2 ]GRID grid.452356.3, ISNI 0000 0004 0518 1285, Education and Training, Dasman Diabetes Institute, ; Dasman, Kuwait City, Kuwait

[3 ]GRID grid.452356.3, ISNI 0000 0004 0518 1285, Nursing Department, , Dasman Diabetes Institute, ; Dasman, Kuwait City, Kuwait

[4 ]GRID grid.452356.3, ISNI 0000 0004 0518 1285, Clinical Laboratory, , Dasman Diabetes Institute, ; Dasman, Kuwait City, Kuwait

[5 ]GRID grid.452356.3, ISNI 0000 0004 0518 1285, Clinical Research, , Dasman Diabetes Institute, ; Dasman, Kuwait City, Kuwait

[6 ]GRID grid.1006.7, ISNI 0000 0001 0462 7212, Institute of Cellular Medicine, , Newcastle University, ; Newcastle upon Tyne, NE2 4HH UK

Author information

Ali M. Aldibbiat http://orcid.org/0000-0002-1493-4571

Article

Publisher ID: 694

DOI: 10.1007/s13300-019-00694-z

PMC ID: 6848697

PubMed ID: 31559530

SO-VID: 2e62354f-df4e-4345-a2a5-829eca803c1b

History

Date received : 17 July 2019

Custom metadata

ScienceOpen disciplines: Endocrinology & Diabetes

Keywords: chronic diseases,diabetes mellitus,diabetic foot ulcer,informal caregiver,patient engagement

Data availability:

ScienceOpen disciplines: Endocrinology & Diabetes

Keywords: chronic diseases, diabetes mellitus, diabetic foot ulcer, informal caregiver, patient engagement

Is There a Role for Informal Caregivers in the Management of Diabetic Foot Ulcers? A Narrative Review

Read this article at

Abstract

Related collections

Bioscientifica Open Endocrinology

Most cited references 45

IWGDF guidance on the diagnosis and management of foot infections in persons with diabetes.

Diabetic Foot Complications and Their Risk Factors from a Large Retrospective Cohort Study

Causal pathways for incident lower-extremity ulcers in patients with diabetes from two settings.

Author and article information

Contributors

Journal

Affiliations

Author information

Article

History

Categories

Custom metadata

Comments

Comment on this article

Similar content 405

Cited by 13

Most referenced authors 959