Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review

Netten, Jaap J. van; Raspovic, Anita; Lavery, Lawrence A.; Monteiro‐Soares, Matilde; Rasmussen, Anne; Sacco, Isabel C.N.; Bus, Sicco A.

doi:10.1002/dmrr.2701

Cited by 277 publications

(236 citation statements)

References 112 publications

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“…The ‘ayes’ have been gathering stronger evidence of ND value in various DSPN situations. In two new papers, the IWGDF has considered ND reports for the first time in a systematic review and guidance for preventing foot ulcers in at-risk diabetes patients [1,2]. It may now be an appropriate time for our thought leaders to re-evaluate the possibility that ND has significant promise for DSPN.…”

Section: Discussionmentioning

confidence: 99%

“…Van Netten et al [1], in their comprehensive review on prevention of DFU in the at-risk patient, included ND in their summary of surgical methods, stating, ‘Surgical interventions can be effective in selected patients, but the evidence base is small’.…”

Section: Meta-analyses and Reviewsmentioning

confidence: 99%

“…ND has never been widely adopted, and proponents and skeptics hold differing strong opinion about its appropriate use. A recent systematic review of diabetic foot ulcer (DFU) treatments [1] and fresh guidance on ulcer prevention from the International Working Group on the Diabetic Foot (IWGDF) both now mention ND [2]. A review of published evidence about this external neurolysis technique in diabetes is timely and appropriate.…”

Section: Introductionmentioning

confidence: 99%

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Nerve decompression and neuropathy complications in diabetes: Are attitudes discordant with evidence?

Nickerson¹

2017

Diabetic Foot & Ankle

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External neurolysis of the nerve at fibro-osseous tunnels has been proprosed to treat or prevent signs, symptoms, and complications in the lower extremity of diabetes patients with sensorimotor polyneuropathy. Nerve decompression is justified in the presence of symptomatic compressed nerves in the several fibro-osseous tunnels of the extremities, which are known to be frequent in diabetes. Quite a body of literature has accumulated reporting results after such nerve decompression in the leg, describing pain relief and sensibility improvement, as well as balance recovery, diabetic foot ulcer prevention, curtailed ulcer recurrence risk, and amputation avoidance.Historical academic hesitance to endorse surgical treatments for pain and numbness in diabetes was based primarily on the early retrospective reports’ potential for bias and placebo effects, and that the hypothetical basis for surgery lies outside the traditional etiology paradigm of length-dependent axonopathy. This reticence is here critiqued in view of recent studies using objective, measured outcome protocols which nullify such potential confounders. Pain relief is now confirmed with Level 1 studies, and Level 2 prospective information suggests protection from initial diabetic foot ulceration and most neuropathic ulcer recurrences. In view of the potential for nerve decompression to be useful in addressing some of the more difficult, expensive, and life altering complications of diabetic neuropathy, this secondary compression thesis and operative treatment methodology may deserve reassessment.

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Section: Discussionmentioning

confidence: 99%

Section: Meta-analyses and Reviewsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nerve decompression and neuropathy complications in diabetes: Are attitudes discordant with evidence?

Nickerson¹

2017

Diabetic Foot & Ankle

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“…Результаты этой работы имеются в свободном доступе в журнале Diabetes / Metabolism Research and Reviews [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23].…”

Section: клинические рекомендацииunclassified

Manual and documents of International Working Group on the Diabetic Foot 2015 for prevention and treatment of diabetic foot diseases: the achievement of argumentative consensus (Russian cut version)

Баккер¹,

Апельквист²,

Липски³

et al. 2016

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“…Optimal diabetes management, daily foot care, education for the person with diabetes and their family, along with screening and risk assessment are all critical aspects for prevention of diabetic foot ulcer [11,12]. For effective education of diabetic patients, especially those at high risk of complications it is crucially important that healthcare professionals develop their understanding of the patient perspective to increase their self-confidence and self-efficacy.…”

Section: Introductionmentioning

confidence: 99%

Effect of Self-Efficacy Enhancing Intervention Training on Clinical Health Status of Diabetic Patients at High-Risk for Leg Problems

Ali¹

2017

J Pat Care

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Egypt has more diabetic individuals than any other country, with high incidence of foot problems and amputations. This study was aimed at evaluating the effect of a self-efficacy enhancing intervention training (SEEIP) on the clinical health status of diabetic patients at high risk for leg problems. The study was conducted in the diabetic outpatient clinic in Ain-Shams Specialized University Hospital in using a randomized controlled trial study design. It included a sample of 60 diabetic patients randomized an intervention group of 30 patients to attend the program and an equal control group following the routine diabetic care in the setting. The data collection tools were an interview questionnaire sheet, and adiabetes clinical/lab form, the self-efficacy assessment form for diabetic patients, and a leg physical assessment sheet. The study was carried out through preparatory, assessment, planning, implementation, and evaluation phases. The training intervention consisted of five efficacy-enhancing sessions at weekly intervals. For evaluation, two posttests were carried out at one and six months after the end of the program. The work was from September 2014 to August 2015. The study revealed statistically significant improvements in the study group at the post-and follow-up in lower limb physical findings (p<0.001), compliance with medications, more days of intake of medications, of following diet, exercise, and practicing foot care during last week (p<0.001), perception of health, and self-confidence (p<0.001), hypertension (p<0.001), random blood sugar (p<0.001), glycated Hb (p<0.001), and total cholesterol (p=0.001). There were statistically significant positive correlation between the scores of self-confidence and foot self-care (r=0.96), and between the number of abnormal signs and the level of HbA1c, while the total number of abnormal signs correlated negatively with the score of self-confidence and foot self-care. The level of HbA1c, it correlated negatively with the scores of self-confidence and foot self-care. In conclusion, increasing diabetic patients' self-confidence and self-efficacy can improve their self-care practices, with subsequent positive impacts on their general and feet health status and diabetic control. The implementation of self-efficacy enhancing training programs is recommended with the use of the developed illustrated booklet as an educational aid for diabetic patients whom at risk for leg problems. More research is needed to investigate the longterm effect of such educational interventions.

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Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review

Cited by 277 publications

References 112 publications

Nerve decompression and neuropathy complications in diabetes: Are attitudes discordant with evidence?

Nerve decompression and neuropathy complications in diabetes: Are attitudes discordant with evidence?

Manual and documents of International Working Group on the Diabetic Foot 2015 for prevention and treatment of diabetic foot diseases: the achievement of argumentative consensus (Russian cut version)

Effect of Self-Efficacy Enhancing Intervention Training on Clinical Health Status of Diabetic Patients at High-Risk for Leg Problems

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