Is There an Association between Sleep Disorders and Diabetic Foot? A Scoping Review

Abstract

Diabetic foot is associated with a low quality of life since physical disabilities, mood disturbances and psychological disorders are frequent. One of the most important biological processes to ensure quality of life is sleep. Sleep disorders can impair glycemic control in patients with diabetes mellitus or even cause long-term type 2 diabetes mellitus. The aim of this study is to carry out a scoping review about the association between sleep cycle disorders and diabetic foot. PubMed, Scopus, CINAHL, PEDro, Cochrane Library, SCIELO and EMBASE databases were chosen for the search and the following terms were used: “diabetic foot”,“sleep*”,“rest-activity”,“mood” and“behavior”. All the studies should include outcome variables about sleep and diabetic foot. Finally, 12 articles were selected, all of whichwere observational. The most frequent variables were those regarding diabetic foot ulcer aspects and diabetic neuropathy on one side, and obstructive sleep apnea, sleep duration and sleep quality on the other side. The results suggest that there is a possible association between obstructive sleep apnea and the presence or history of diabetic foot ulcers. No direct associations between sleep quality or sleep duration and diabetic foot or diabetic foot ulcer variables have been found.

Habitual Physical Activity of People with or at Risk of Diabetes-Related Foot Complications

“…For a person with diabetes, reduced sleep can also impact the inclination to undertake self-care behaviours and exercise [53]. Specific data on sleep in people with or at risk of diabetes-related foot complications is limited, with a recent scoping review identifying 12 heterogeneous observational studies that investigated a variety of foot health and sleep outcomes [54]. The authors suggest a possible association between obstructive sleep apnea and the presence or history of diabetes-related foot ulceration, but high-quality research is needed to understand the role sleep duration and quality has on the prevention or treatment of diabetes-related foot complications.…”

Effects of evidence‐based care on diabetic foot ulcers: A meta‐analysis

“…Diabetes mellitus (DM) is a common endocrinological disease, and the incidence of the disease is increasing annually due to the influence of diet, living habits and genetic factors 1 . The clinical features of DM include excessive drinking, eating, urination and weight loss 2,3 . If blood glucose is not effectively controlled, it will lead to a series of complications, of which diabetic foot is the most common 2,3 .…”

“… 1 The clinical features of DM include excessive drinking, eating, urination and weight loss. 2 , 3 If blood glucose is not effectively controlled, it will lead to a series of complications, of which diabetic foot is the most common. 2 , 3 According to the available statistics, 20%–25% of the approximately 150 million people with DM worldwide are at risk of developing foot gangrene or ulcers during their treatment course.…”

“… 2 , 3 If blood glucose is not effectively controlled, it will lead to a series of complications, of which diabetic foot is the most common. 2 , 3 According to the available statistics, 20%–25% of the approximately 150 million people with DM worldwide are at risk of developing foot gangrene or ulcers during their treatment course. 4 Diabetic foot is caused by peripheral neuropathy in the feet of diabetic patients.…”

A Novel Bathing Therapeutic Approach for Diabetic Foot Ulcers

“…Besides, diabetic patients developing foot ulcers are at a much higher risk of death, experiencing an increase in three-year mortality risk from 13% to 28% [6]. Furthermore, such higher morbidity and mortality burden is associated with a significant psychological and physical stress to the patient, resulting in a poor quality of life [7], as well as with a significant increase in healthcare utilization. The diabetic foot ulcer is thus a major health care concern, incurring significant health care costs [8][9][10].…”