The system of care for the diabetic foot: objectives, outcomes, and opportunities

Abstract

Most cases of lower extremity limb loss in the United States occur among people with diabetes who have a diabetic foot ulcer (DFU). These DFUs and the associated limb loss that may occur lead to excess healthcare costs and have a large negative impact on mobility, psychosocial well-being, and quality of life. The strategies for DFU prevention and management are evolving, but the implementation of these prevention and management strategies remains challenging. Barriers to implementation include poor access to primary medical care; patient beliefs and lack of adherence to medical advice; delays in DFU recognition; limited healthcare resources and practice heterogeneity of specialists. Herein, we review the contemporary outcomes of DFU prevention and management to provide a framework for prioritizing quality improvement efforts within a resource-limited healthcare environment.

Knowledge and Practice of Foot Care in Diabetic Inpatients: A Descriptive Cross-Sectional Study

“…Efforts toward this target included the diagnosis of individuals with high DFU risk, their optimal metabolic control, and follow-up, as well as self-foot examination and patient training by improving their foot care knowledge (15). However, diabetic patients having foot care knowledge were determined to be in the range of only 33%-48% even in recent researches (12,16). This rate was about 44% in our study.…”

Barriers and enablers to proper diabetic foot care amongst community dwellers in an Asian population: a qualitative study

“…To a large extent, these negative outcomes occur due to late diagnosis and improper diabetic foot care. In fact, the majority of people with diabetes do not receive or practice the foot care recommended by current guidelines (22).…”

Diabetic Foot Care: Knowledge and Practice

“…Knowledge was measured using 10 questions covering good foot care practice in the areas of feet washing techniques, skin and nail care and foot wear care. Each "yes" answer carried one [5] point and zero point for a "no". The points were then added up to provide total knowledge score.…”

“…The disease represents nearly 35% of all hospital admissions in diabetic specialized clinics [3]. DF complication is the major cause of a significant loss of quality and years of life of diabetic patients [4,5]. In term of cost, it represents 12-15% of the overall cost associated with diabetes and up to 40% in developing countries [5,6].…”