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Patient education for preventing diabetic foot ulceration
Author(s) -
Dorresteijn Johannes A. N.,
Valk Gerlof D.
Publication year - 2012
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2237
Subject(s) - medicine , amputation , psychological intervention , intensive care medicine , diabetic foot , incidence (geometry) , diabetes mellitus , population , foot (prosody) , diabetic foot ulcer , evidence based practice , patient education , evidence based medicine , physical therapy , surgery , alternative medicine , nursing , environmental health , pathology , linguistics , philosophy , physics , optics , endocrinology
Summary Treatment of diabetic foot ulceration is very challenging, costly and often needs to be of long duration. This leads to substantial economic burden. Population‐based research suggests that a meaningful reduction of the incidence of amputations caused by diabetes mellitus has already been achieved since the St. Vincent resolution in 1989. Still, it cannot be inferred from these studies that the current preventive efforts are (cost‐)effective because reduction of amputation incidence can also be the result of improvements in ulcer treatment. Nevertheless, education of people with diabetes is widely advocated and implemented in standard practice. Despite the fact that preventive interventions are often combined in daily practice, there is little scientific evidence demonstrating the effect of those efforts. In systematically reviewing the evidence, there is insufficient evidence that limited patient education alone is effective in achieving clinically relevant reductions in ulcer and amputation incidence. To date, high quality evidence that more complex interventions including patient education can prevent diabetic foot ulceration is not available either. This, however, should be interpreted as lack of evidence rather than evidence of no effect. Future directions for research and practice may be to concentrate preventive effort on those patients who appear to be at highest risk of foot ulceration after careful screening and selection. Copyright © 2012 John Wiley & Sons, Ltd.