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Diabetic Foot Care

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1. Preventative Foot Care for Patients with Diabetes: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Preventative Foot Care for Patients with Diabetes: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Preventative Foot Care for Patients with Diabetes: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Preventative Foot Care for Patients with Diabetes: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Preventative Foot Care for Patients with Diabetes: A Review of Clinical Effectiveness, Cost (...) -Effectiveness, and Guidelines Last updated: November 14, 2018 Project Number: RC1041-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of providing preventative foot care for patients with diabetes and asymptomatic feet? What is the cost-effectiveness of providing preventative foot care for patients with diabetes and asymptomatic feet? What are the evidence-based guidelines regarding the provision

2018 Canadian Agency for Drugs and Technologies in Health - Rapid Review

2. A systematic review of the impact of foot-care education on self-efficacy and self-care in diabetic foot disease

A systematic review of the impact of foot-care education on self-efficacy and self-care in diabetic foot disease Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated

2019 PROSPERO

3. Rehabilitation technology for self-care: Customised foot and ankle exercise software for people with diabetes. (PubMed)

Rehabilitation technology for self-care: Customised foot and ankle exercise software for people with diabetes. To develop and validate the content of a free web-based software (desktop and mobile applications) for the self-management of and customised foot-ankle exercises for people with diabetes and diabetic neuropathy.The development of the programme was based on gamification principles and addressed three main areas: foot care recommendations; self-assessment of feet according to the main (...) complications of diabetic neuropathy; and customised foot-ankle exercises to strengthen muscles, increase the range of motion and improve functionality. The content was validated using the Delphi methodology and a quantitative approach in two rounds with diabetes specialists (n = 9) and users with diabetes (n = 20). A 70% approval rate was considered sufficient in the second round for final validation purposes. The data analysis was conducted using descriptive statistics, absolute and relative frequencies

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2019 PLoS ONE

4. Retrospective analysis of diabetic foot osteomyelitis management and outcome at a tertiary care hospital in the UK. (PubMed)

Retrospective analysis of diabetic foot osteomyelitis management and outcome at a tertiary care hospital in the UK. This study aimed to analyse retrospectively management and outcomes of the diabetic foot osteomyelitis (DFOM) multi-disciplinary team at St Thomas' Hospital, London.Patients admitted during 2015 with diagnosis of DFOM were included. Data were obtained from medical and microbiology records.275 patients were admitted for DF infection in 2015: 45.1% had OM (75% males). 40% were newly

2019 PLoS ONE

5. The effects of self-efficacy enhancing program on foot self-care behaviour of older adults with diabetes: A randomised controlled trial in elderly care facility, Peninsular Malaysia. (PubMed)

The effects of self-efficacy enhancing program on foot self-care behaviour of older adults with diabetes: A randomised controlled trial in elderly care facility, Peninsular Malaysia. Self-care behaviour is essential in preventing diabetes foot problems. This study aimed to evaluate the effectiveness of health education programs based on the self-efficacy theory on foot self-care behaviour for older adults with diabetes.A randomised controlled trial was conducted for 12 weeks among older adults (...) with diabetes in elderly care facility in Peninsular Malaysia. Six elderly care facility were randomly allocated by an independent person into two groups (intervention and control). The intervention group (three elderly care facility) received a health education program on foot self-care behaviour while the control group (three elderly care facility) received standard care. Participants were assessed at baseline, and at week-4 and week-12 follow-ups. The primary outcome was foot-self-care behaviour. Foot

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2018 PLoS ONE

6. 11. Microvascular Complications and Foot Care: <i>Standards of Medical Care in Diabetes-2019</i>. (PubMed)

11. Microvascular Complications and Foot Care: Standards of Medical Care in Diabetes-2019. The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating (...) the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.© 2018 by the American Diabetes Association.

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2019 Diabetes Care

7. Negative pressure wound therapy for treating foot wounds in people with diabetes mellitus. (PubMed)

Negative pressure wound therapy for treating foot wounds in people with diabetes mellitus. Foot wounds in people with diabetes mellitus (DM) are a common and serious global health issue. People with DM are prone to developing foot ulcers and, if these do not heal, they may also undergo foot amputation surgery resulting in postoperative wounds. Negative pressure wound therapy (NPWT) is a technology that is currently used widely in wound care. NPWT involves the application of a wound dressing (...) attached to a vacuum suction machine. A carefully controlled negative pressure (or vacuum) sucks wound and tissue fluid away from the treated area into a canister. A clear and current overview of current evidence is required to facilitate decision-making regarding its use.To assess the effects of negative pressure wound therapy compared with standard care or other therapies in the treatment of foot wounds in people with DM in any care setting.In January 2018, for this first update of this review, we

2018 Cochrane

8. Diabetic foot complications

on a structurally abnormal, insensate foot. Ulcers act as a portal of entry for bacterial infections. Preventing and/or healing ulcers helps prevent infections and thereby minimise limb loss risk. Initial evaluation and early management may be by general practitioners; however, there should be a low threshold to refer to a interdisciplinary diabetic foot care clinic or inpatient unit. This is particularly true if there is any loss of sensation or signs of peripheral artery disease. Leg amputation should (...) Diabetic foot complications Diabetic foot complications - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Diabetic foot complications Last reviewed: February 2019 Last updated: March 2018 Summary Diabetic foot complications, including ulcers and infections, are a common and costly complication of diabetes mellitus. The majority of diabetic foot ulcers are caused by repetitive trauma sustained during activity

2018 BMJ Best Practice

9. The Effect of Telemedicine Follow-up Care on Diabetes-Related Foot Ulcers: A Cluster Randomized Controlled Noninferiority Trial

The Effect of Telemedicine Follow-up Care on Diabetes-Related Foot Ulcers: A Cluster Randomized Controlled Noninferiority Trial To evaluate whether telemedicine (TM) follow-up of patients with diabetes-related foot ulcers (DFUs) in primary health care in collaboration with specialist health care was noninferior to standard outpatient care (SOC) for ulcer healing time. Further, we sought to evaluate whether the proportion of amputations, deaths, number of consultations per month, and patient (...) in the proportion of deaths, number of consultations, or patient satisfaction between groups, although the direction of the effect estimates for these clinical outcomes favored the TM group.The results suggest that use of TM technology can be a relevant alternative and supplement to usual care, at least for patients with more superficial ulcers.© 2017 by the American Diabetes Association.

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2018 EvidenceUpdates

10. Self-efficacy of foot care behaviour of elderly patients with diabetes (PubMed)

Self-efficacy of foot care behaviour of elderly patients with diabetes Elderly patients with diabetes are at a high risk of contracting diabetic foot problems. Self-efficacy is essential to help improve foot care behaviour.To identify levels of self-efficacy and foot care behaviour and their relationship with demographic characteristics in elderly patients with diabetes.A cross-sectional study was conducted in two general hospitals in Malaysia from May to June 2015. Diabetes patients aged 60 (...) -efficacy (β = 0.41, p < 0.001) and gender (β = 0.30, p < 0.001) with foot care behaviour.Self-efficacy can be incorporated in diabetes education to improve foot care behaviour. High-risk patients should be taught proper foot inspection and protection as well as the merits of skin care to prevent the occurrence of diabetic foot problems.

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2017 Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia

11. Operational Delivery of the Multi-Disciplinary Care Pathway for Diabetic Foot Problems

Operational Delivery of the Multi-Disciplinary Care Pathway for Diabetic Foot Problems 1 Operational Delivery of the Multi-Disciplinary Care Pathway for Diabetic Foot Problems April 2016 Joint Specialty Recommendations from: British Orthopaedic Association, British Orthopaedic Foot and Ankle Society, Vascular Society, Diabetes UK, Association of British Clinical Diabetologists, Foot in Diabetes UK; British Association of Prosthetists and Orthotists Aim The aim of this document is to provide (...) a framework for the operational delivery of hospital Trust based diabetic foot services, ensuring that patients with acute diabetic foot disease receive the same high quality of care irrespective of where they present. Background (from NG19) Foot complications are common in people with diabetes. It has been estimated that between 5 and 7% of people with diabetes have current or previous foot ulceration 1,2 . Diabetes is the most common cause of non-traumatic limb amputation, with diabetic foot ulcers

2016 British Orthopaedic Association

12. The effects of adding adjunctive hyperbaric oxygen therapy to standard wound care for diabetic foot ulcers: a systematic review with meta-analysis and trial sequential analysis

The effects of adding adjunctive hyperbaric oxygen therapy to standard wound care for diabetic foot ulcers: a systematic review with meta-analysis and trial sequential analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability

2019 PROSPERO

13. Suspected Osteomyelitis of the Foot in Patients with Diabetes Mellitus.

):121-132. 22. Lavery LA, Armstrong DG, Peters EJ, Lipsky BA. Probe-to-bone test for diagnosing diabetic foot osteomyelitis: reliable or relic? Diabetes Care. 2007;30(2):270-274. 23. Shone A, Burnside J, Chipchase S, Game F, Jeffcoate W. Probing the validity of the probe-to-bone test in the diagnosis of osteomyelitis of the foot in diabetes. Diabetes Care. 2006;29(4):945. 24. Grayson ML, Gibbons GW, Balogh K, Levin E, Karchmer AW. Probing to bone in infected pedal ulcers. A clinical sign (...) Suspected Osteomyelitis of the Foot in Patients with Diabetes Mellitus. Date of origin: 1995 Last review date: 2012 ACR Appropriateness Criteria ® 1 Suspected Osteomyelitis-Diabetic Patient American College of Radiology ACR Appropriateness Criteria ® Clinical Condition: Suspected Osteomyelitis of the Foot in Patients with Diabetes Mellitus Variant 1: Soft-tissue swelling without neuropathic arthropathy or ulcer. Radiologic Procedure Rating Comments RRL* X-ray foot 9 Initial study. Radiographs

2019 American College of Radiology

14. Foot Care Interventions for Adults in the Community Setting: Clinical Effectiveness and Guidelines

Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What is the clinical effectiveness of basic foot care treatments for adult patients in a community setting? What is the clinical effectiveness of advanced foot care treatments for patients with peripheral vascular disease or diabetes in a community setting? What are the evidence-based guidelines regarding basic or advanced foot care treatments in patients with peripheral vascular disease (...) or diabetes? Key Message Two randomized controlled trials and one evidence-based guideline were identified regarding foot care for adult patients in a community setting. Files Rapid Response Summary of Abstracts Published : July 20, 2018 Related Content Follow us: © 2019 Canadian Agency for Drugs and Technologies in Health Get our newsletter:

2018 Canadian Agency for Drugs and Technologies in Health - Rapid Review

15. Diabetic foot ulcer incidence and survival with improved diabetic foot services: an 18-year study. (PubMed)

presenting with first ulcer and aged < 65 years, 50% for those aged 65-74 years and 25% for those aged 75-81 years (P < 0.0001). In those with peripheral vascular disease 5-year survival was 35% (P <0.001).Integrated care for the diabetic foot in one National Health Service (NHS) health service area over 18 years was associated with a reduction in first presentations of diabetic foot ulceration, but failed to reduce recurrent ulceration. Cumulative prevalence of all ulcers continues to increase (...) . Monitoring ulceration incidence can inform audit and planning of diabetic foot care services. Survival is better than reported previously in persons < 65 years and in the absence of peripheral vascular disease.© 2019 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

2019 Diabetic Medicine

16. Associations of health literacy with risk factors for diabetic foot disease: a cross-sectional analysis of the Southern Tasmanian Health Literacy and Foot Ulcer Development in Diabetes Mellitus Study. (PubMed)

Associations of health literacy with risk factors for diabetic foot disease: a cross-sectional analysis of the Southern Tasmanian Health Literacy and Foot Ulcer Development in Diabetes Mellitus Study. Poor health literacy (HL) is associated with poorer health outcomes in diabetes but little is known about its effects on foot disease. This study was aimed to determine the associations between HL and diabetic foot disease.This is a cross-sectional analysis of baseline data from a prospective (...) study of foot disease.Attendees of the Royal Hobart Hospital's Diabetes outpatient clinics.222 people with type 1 or type 2 diabetes aged >40 years and without a history of foot disease, psychotic disorders or dementia.Outcomes were peripheral neuropathy, peripheral arterial disease and foot deformity according to published guidelines. The exposure, HL, was measured using the short form Test of Functional Health Literacy in Adults (S-TOFHLA) and the Health Literacy Questionnaire (HLQ). Covariates

2019 BMJ open

17. Quantifying the costs and profitability of care for diabetic foot ulcers treated in a multidisciplinary setting. (PubMed)

Quantifying the costs and profitability of care for diabetic foot ulcers treated in a multidisciplinary setting. Increasing Wound, Ischemia, and foot Infection (WIfI) stage has previously been shown to be associated with prolonged wound healing time, higher number of surgical procedures, and increased cost of care in patients with diabetic foot ulcers (DFUs) treated in a multidisciplinary setting. However, the profitability of this care model is unknown. We aimed to quantify the hospital costs (...) and net margins associated with multidisciplinary DFU care.All patients presenting to our multidisciplinary diabetic limb preservation service (January 2012-June 2016) were enrolled in a prospective database. Inpatient and outpatient costs and net margin (U.S. dollars) were calculated for each wound episode (initial visit until complete wound healing) overall and per day of care according to WIfI classification.A total of 319 wound episodes in 248 patients were captured. Patients required an average

2019 Journal of Vascular Surgery

18. Contribution of 30-day readmissions to the increasing costs of care for the diabetic foot. (PubMed)

Contribution of 30-day readmissions to the increasing costs of care for the diabetic foot. The inpatient cost of care for diabetic foot ulcers (DFUs) has been estimated to be $1.4 billion annually in the United States. We have previously demonstrated that the risk of 30-day unplanned readmission for patients with DFU is nearly 22%. Our aim was to quantify the cost of readmissions for patients admitted with DFU.All patients presenting to our multidisciplinary diabetic limb preservation service (...) from June 2012 to June 2016 were enrolled in a prospective database. Inpatient costs and net margins were calculated overall and for index admissions vs 30-day unplanned readmissions.A total of 249 admissions for 150 patients were included. Of these, 206 admissions were index admissions and 43 were 30-day readmissions. The most common reason for readmission was the foot wound (49%), followed by a bypass wound (14%), renal complications (9%), and other systemic complications. Surgical interventions

2019 Journal of Vascular Surgery

19. Reasons for (non-)adherence to self-care in people with a diabetic foot ulcer. (PubMed)

Reasons for (non-)adherence to self-care in people with a diabetic foot ulcer. We aimed to explore reasons for (non-)adherence to self-care among people with diabetic foot ulcers, as well as barriers and solutions to improving their self-care adherence. We performed a qualitative study, recruiting people with a diabetic foot ulcer from a community diabetic foot clinic. Semistructured interviews were held with participants. Data saturation occurred after 9 and was confirmed after 11 participant (...) identified included poor mobility and visibility, difficulty wearing offloading devices or using wound dressings, and frustration with lack of progress. Solutions to improve adherence included integrating self-care as routine, improved education, more external help and improving visibility. All five WHO adherence dimensions played a role in (non-)adherence to diabetic foot ulcer self-care. We conclude that adherence to recommended diabetic foot ulcer self-care was limited at best, and reasons

2019 Wound Repair and Regeneration

20. Racial factors and inpatient outcomes among patients with diabetes hospitalized with foot ulcers and foot infections, 2003-2014. (PubMed)

between the two races as quality of care and access to healthcare has improved.Patients over 18 years old with a principal diagnosis of diabetic foot complications and secondary diagnosis of Diabetes Mellitus were selected. We compared the primary outcome of foot amputations between Black and White patients. Adjusted rates, odds ratios (aOR) and trends of foot amputations among Black and White patients were studied. Healthcare utilization was measured via length of hospital stay (LOS). Of 262,924 (...) Racial factors and inpatient outcomes among patients with diabetes hospitalized with foot ulcers and foot infections, 2003-2014. In patients with diabetes, foot amputations among Black patients have been historically higher compared with White patients. Using the National Inpatient Sample database, we sought to determine if disparities in foot amputations and resource utilization have improved over time. We hypothesized there would be improvements and reduced differences in foot amputations

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2019 PLoS ONE

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