Prevention of Diabetic Foot Ulcer in High Risk Patient: The Role of Internist in Providing Adequate Foot Care

Abstract

Background and aim: The awareness and practice of diabetes foot prevention by internist through routine examination and patient education remains less than optimal. This study aimed to evaluate the quality of care of internist in performing foot care in high-risk patients. Methods: A cross sectional study was conducted in a tertiary care hospital in Jakarta, Indonesia. Type 2 diabetes mellitus subjects with high-risk foot complication were included in this study. Each subject filled-in a questionnaire investigating whether they had received information about proper foot care practice and whether they have ever had their feet examined by an internist at their present consultation. Multivariate logistic regression were performed. Results: 368 patients were recruited, 130 of them (35.3%) treated by endocrinologists. 71.20% patients did not received any information on foot care and 54.08% patients did not received any foot examination. Foot care information was 1.6 times more frequently provided to patient with longer diabetes duration and 2 times more frequently provided to those who had history of diabetic foot ulcer. Meanwhile, foot examination was 1.5 times more frequently provided to those with longer diabetes duration and had a history of Lower Extremity Amputation. Compare to non-endocrinologist internist, endocrinologists tend to provide foot education and perform foot examination 2.2 to 2.5 times more frequently than non-endocrinologists. Conclusion: Most of patients with high risk foot problems were not offered adequate foot care. It is necessary to develop strategies to improve the care and awareness among health professionals treating patients with diabetes especially internist.

Three Years Survival and Factor Predicting Amputation or Mortality in Patients with High Risk for Diabetic Foot Ulcer in Fatmawati General Hospital, Jakarta

“…This was a cohort retrospective study as continuation of previous report “ Diabetic Foot Ulcer in High Risk Patient: the Role of Internist in Providing Adequate Foot Care ” by Kshanti et al, 15 reviewing 487 outpatient’s medical records in Fatmawati General Hospital who visited internal medicine clinic during January to December 2016. The inclusion criteria for this study were: patients with T2DM, aged ≥18 years old, visiting the clinic during study period, and was registered to the previous research database.…”