Self-Care in Type 2 Diabetes Patients with Urgency Lower Limb Amputation: The Influence of Sex, Marital Status and Previous Amputations

Abstract

Aim: Lower limb amputation (LLA) is a severe consequence of type 2 diabetes mellitus (T2DM), and can affect up to 1% of T2DM patients, leading to an increased risk of premature mortality. Among the factors to predict LLA, it has been highlighted sex, marital status, and previous amputation. However, there is a lack of information about the association between these predictive factors, self-care, and urgency LLA in T2DM patients. Purpose: To verify the behavior of self-care and to relate it with the predictive factors (sex, marital status, and previous amputation) in urgency LLA T2DM patients. Patients and Methods: Non-interventional study, with 106 T2DM patients who were in the postoperative period of urgency LLA caused by complications resulting from T2DM. A structured questionnaire was used for sociodemographic and clinical characterization of the sample as well as the Summary of Diabetes Self-Care Activities (SDSCA) tool. It was used the Wilcoxon, Friedman, and Mann-Whitney tests (median, nonparametric populations) to assess the significance of the differences between groups (sex, marital status, and previous amputation), also Spearman correlation coefficient to assess the association between the data (comparison between diagnostic time, sex, previous amputation, ethnicity and systolic arterial hypertension) and a logistic regression analysis considering the item SDSCA related to sex, age and marital status (with partner). Results: Significant differences (p<0.05) in the questions "Specific Food" and "Foot care" were found when the participants were grouped by sex. In the relation to marital status, significant differences (p<0.05) were observed for the question "Specific Food". No differences were found between groups with or without previous amputation. Conclusion: By SDSCA tool, we were able to report that T2DM patients submitted to urgency LLA presented differences in self-care, particularly for sex and marital status.

Foot self‐care behaviour in type 2 diabetes adults with and without comorbid heart failure

“…Unlike a previous study (Domingos et al, 2021 ), our study showed that marital status is one of the important predictors of foot self‐care behaviour among T2D adults without comorbid HF. The current study suggests that adults with T2D are married were less likely to perform the recommended foot self‐care behaviours.…”

Foot Care Behavior Among People With Type 2 Diabetes Mellitus: Overview and Sociodemographic Factors Impact

“…The results of this study are inconsistent with previous research, which stated that gender has a significant effect on foot care behavior (Domingos et al, 2021;Pourkazemi et al, 2020;Sharoni et al, 2017;Usta et al, 2019). Females look better in foot care, painstaking, and more capable of doing foot care than males (Usta et al, 2019).…”

“…Individual sociodemographic characteristics are essential in self-care behavior as a diabetic foot ulcer prevention effort. Several previous studies have shown that sociodemographic factors influence foot care behavior, including age (Miikkola et al, 2019;Sari et al, 2020), gender (Domingos et al, 2021;Pourkazemi et al, 2020;Sharoni et al, 2017;Usta et al, 2019), marital status (Domingos et al, 2021;Pourkazemi et al, 2020), an education level (Ahmed et al, 2019;D'Souza et al, 2016;Pourkazemi et al, 2020;Sari et al, 2020;Syed et al, 2019), income level (D'Souza et al, 2016;Khaliq et al, 2019;Syed et al, 2019), family system/type or support (D'Souza et al, 2016;Sari et al, 2020), and ethnicity (Nwasuruba et al, 2007;Tan et al, 2020). Older people with T2DM often experience difficulty carrying out self-care, including foot selfcare behavior (Miikkola et al, 2019).…”

“…Females showed good foot care behavior because they were more painstaking and capable of performing foot care (Usta et al, 2019). People with T2DM with a life partner have better foot care behavior associated with their partners' social support in daily selfmanagement practices (Domingos et al, 2021;Pourkazemi et al, 2020). Higher education and income are associated with higher levels of knowledge and ability to access health services and health financing (Ahmed et al, 2019;D'Souza et al, 2016;Khaliq et al, 2019;Pourkazemi et al, 2020;Sari et al, 2020;Syed et al, 2019).…”

Extensive thrombosis with amputation of digit I pedis dextra: A case report in Indonesian adult with type 2 diabetes mellitus

“…Each thrombectomy was performed 3 times, the flow was present after each thrombectomy, but it weakened again. Subsequently, a lower-extremity amputation procedure (digit I pedis dextra) was performed [10] . The condition of the patient's legs before and after the amputation can be seen in Fig.…”