Prevalence and Risk Evaluation of Diabetic Complications of the Foot Among Adults With Type 1 and Type 2 Diabetes in a Large Canadian Population (PEDAL Study)

Aronson, Ronnie; Chu, Lisa; Joseph, Nicole; Brown, Ruth E.

doi:10.1016/j.jcjd.2020.11.011

Cited by 12 publications

(8 citation statements)

References 39 publications

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“…Although previous publications indicated that onychomycosis is associated with an increased risk of ulceration in patients with diabetic foot disease, 27,28 we did not find enough scientific evidence to support this association 26 . These results are, therefore, in contrast to previous articles describing toenail onychomycosis as an infection that is associated with diabetic foot syndrome and that may contribute to lesion severity 27,28 …”

Section: Discussioncontrasting

confidence: 86%

“…HbA1c) values were associated with the presence of onychomycosis ( p = .039 and p = .04) and were highly correlated with nail thickening with onychomycosis ( p = .003) 6,24 . There was no significant relationship between onychomycosis and ulceration in the included studies ( p = .185) 26 …”

Section: Resultsmentioning

confidence: 90%

“…6,24 There was no significant relationship between onychomycosis and ulceration in the included studies (p = .185). 26 The data extracted from the studies included in this systematic review are summarised in Table 2.…”

Section: Diabetes and Onychomycosis Associationmentioning

confidence: 99%

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Onychomycosis associated with diabetic foot syndrome: A systematic review

Navarro‐Pérez

Tardáguila‐García

García‐Oreja

et al. 2023

Mycoses

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Background: A systematic review was conducted to investigate the prevalence of onychomycosis in patients with diabetes. The association of onychomycosis with risk factors in patients with diabetic foot syndrome was also examined. Methods:The recommendations in the preferred reporting items for systematic reviews and meta-analysis (PRISMA) checklist were applied, and the included studies were assessed using the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) method. Searches were conducted in October 2022 using PubMed (Medline) and Scopus for clinical studies, clinical trials, comparative studies, observational studies, and randomised clinical trials or controlled clinical trials addressing the prevalence and consequences of onychomycosis in patients with diabetes, diagnoses or treatments. Two authors performed the study selection and data extraction, and any discrepancies between the two reviewers were resolved through discussion with a third reviewer. Results:The systematic review included ten studies that met the inclusion criteria, and these studies enrolled 5664 patients with diabetes. Among these patients, 29.18% had onychomycosis that was mainly caused by Trichophyton rubrum. A significant association was found between the occurrence of onychomycosis and the presence of diabetic neuropathy (p = .012) and elevated glycosylated haemoglobin values (p = .039). There was no significant association between onychomycosis and ulceration (p = .185). Eight studies had a grade 4 level of evidence and a grade C recommendation, and one study had a grade 1b level of evidence and a grade A recommendation. Conclusion:The information described in the literature is insufficient and heterogeneous regarding the association of risk factors and ulceration in patients with diabetic foot compared with developing onychomycosis. There is also a need to implement onychomycosis diagnostic testing instead of relying only on a clinical diagnosis.Additional prospective, randomised, comparative studies are needed to increase the quality of studies in the literature.

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Section: Discussioncontrasting

confidence: 86%

Section: Resultsmentioning

confidence: 90%

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Onychomycosis associated with diabetic foot syndrome: A systematic review

Navarro‐Pérez

Tardáguila‐García

García‐Oreja

et al. 2023

Mycoses

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“…However, given the heterogeneous nature of the UK SA population [4], and the unique nature of the UK National Health Service, combined with the social-cultural population mix within the UK [100], it was deemed plausible to explore articles from this perspective, although we recognise that the results of this review may not be transferrable to other countries. It is noteworthy that T2D prevalence has increased across the world; for example, in America and Canada, the SA population are at higher risk of developing T2D [101,102], and the prevalence and needs of SA patients in westernised populations have high rates of health inequalities [103]. Therefore, the findings of this article may be useful for consideration across the world to help explain cultural-health care conflicts and how to improve care delivery.…”

Section: Strengths and Limitations Of The Reviewmentioning

confidence: 94%

Cultural Identity Conflict Informs Engagement with Self-Management Behaviours for South Asian Patients Living with Type-2 Diabetes: A Critical Interpretative Synthesis of Qualitative Research Studies

Patel

Umeh

Poole

et al. 2021

IJERPH

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The prevalence of type-2 diabetes (T2D) is increasing, particularly among South Asian (SA) communities. Previous research has highlighted the heterogeneous nature of SA ethnicity and the need to consider culture in SA patients’ self-management of T2D. We conducted a critical interpretative synthesis (CIS) which aimed to a) develop a new and comprehensive insight into the psychology which underpins SA patients’ T2D self-management behaviours and b) present a conceptual model to inform future T2D interventions. A systematic search of the literature retrieved 19 articles, including 536 participants. These were reviewed using established CIS procedures. Analysis identified seven constructs, from which an overarching synthesizing argument ‘Cultural Conflict’ was derived. Our findings suggest that patients reconstruct knowledge to manage their psychological, behavioural, and cultural conflicts, impacting decisional conflicts associated with T2D self-management and health professional advice (un)consciously. Those unable to resolve this conflict were more likely to default towards cultural identity, continue to align with cultural preferences rather than health professional guidance, and reduce engagement with self-management. Our synthesis and supporting model promote novel ideas for self-management of T2D care for SA patients. Specifically, health professionals should be trained and supported to explore and mitigate negative health beliefs to enable patients to manage social-cultural influences that impact their self-management behaviours.

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“…A detailed description of this registry has been previously reported. [40][41][42] An independent ethics committee approved the protocol, and all patients included in the cohort provided consent for their medical data to be used for research purposes. Informed consent was obtained from HCPs for module B to collect survey responses.…”

Section: Participants and Methodsmentioning

confidence: 99%