Lower limb self-care among diabetic insulin users

Abstract

Introduction: Lower limb neuropathy is one the complications of diabetes mellitus and the most common cause of lower limb amputation. Hence information and self-care advice should be provided to primary healthcare patients to prevent this condition. Objective: To explore insulin users' knowledge of foot self-care. Methods: This quantitative, descriptive, exploratory study was conducted at a Family Health Unit Curitiba-PR of Curitiba, PR, Brazil. The study sample comprised 63 insulin users. Data were collected through a structured questionnaire. Results: Although they reported performing self-care activities, 67% (n = 42) of insulin users declared that they had never received any information on foot self-care. Conclusion: The adherence to self-care practices shown by respondents and the patient empowerment observed in this study indicate the effectiveness of the information on diabetes self-care imparted to patients registered at this health care unit in contributing to the promotion of quality of life.

A Scoping Review of Footwear Worn by People With Diabetes in Low- and Middle-Income Countries: Implications for Ulcer Prevention Programs

“…15,22 Inadequate foot care education and low levels of diabetic foot care awareness, tropical weather, frequent cultural removal of shoes, and poverty were posited to be responsible for the popularity of poor footwear choices. 24,[41][42][43]48,50,52,53,56,59,60,[62][63][64] Prekumar et al's apparent resignation to accepting suboptimal shoes with metal buckles because they were "the most acceptable model that even a poor person could purchase" frames poverty as an insurmountable barrier to proper footwear use for the poor. 52 In light of this evidence, LMIC clinicians and public health programs relying on international guidelines may benefit from questioning whether the recommendations optimize health benefits in their settings given potentially low uptake.…”

“…Open-toed shoes, particularly sandals (also called "chappals") and flip-flops (also called "slippers," "Hawaii chappals," "Hawaii slippers," and "sandals with forking"), were the most common footwear in nearly all (n=20) of the included studies, in clear contrast with the recommendations of international guidelines. 15 The popularity of sandals and flip-flops was largely consistent across samples from different world regions, with lower 41,43,56 and higher 24,58 education levels, lower 43,44,46,62 and higher 55,58 income levels, lower 47,50,57-60 and higher 24,41,46,[52][53][54]56,61,62,64 DFU risk levels, and from more 24,44,46,48,49,54,56,58 or less 41,49,50,52,55,59,60 urban locations, though not all articles thoroughly reported all of these demographic characteristics.…”

“…24,46,47,50,[52][53][54][55][56][57]59 General closed footwear was reported to be used by between 3%-70%. 24,[41][42][43]48,[52][53][54][55][56][57]59,[61][62][63][64] The outlying 70% rate was recorded by Ruiz Roque et al 48 in Curitiba, Brazil, and the 2 studies reporting 3% are both from South India. 52,56 The median rate of closed footwear use is 16%.…”

“…A number of articles reported that many patients had not ever had their feet inspected or been informed about how to care for their feet, including by making appropriate footwear choices, by a health care professional. 24,41,42,48,50,56,60,64 Jain and Rajagopalan 56 pointed out that none of their participants (all of whom had just received surgical treatment for diabetic foot) were advised by their providers regarding footwear, which they characterized as negligence. Large numbers of patients in other studies were judged to have low levels of knowledge regarding diabetic foot self-care, 43,47,49 and some authors recommend more time and energy be spent on patient education.…”

Plano de cuidado farmacêutico ao paciente com Diabetes Mellitus tipo 1

“…É aconselhado também que os pacientes analisem os pés todos os dias, em busca de alguma calosidade ou até mesmo um corte que ele possa ter sofrido e que por falta da sensibilidade nos pés não tenham sentido dor, somente conseguindo detectar esse corte através de análise visual. Além disso, foi demonstrado que a DPN pode também ser evitada pelo uso 28 PLANO DE CUIDADO FARMACÊUTICO AO PACIENTE COM DIABETES MELLITUS TIPO 1 J J J J J J J J J J J J adequado de insulina associado à dieta e à prática de atividade física, juntamente com as ações de autocuidado dos pés (ROQUE et al, 2017).…”