BACKGROUND Diabetes is a common chronic disease,and its global incidence is on the rise.The disease is directly attributed to insufficient insulin efficacy/secretion,and patients are often accompanied by multiple comp...BACKGROUND Diabetes is a common chronic disease,and its global incidence is on the rise.The disease is directly attributed to insufficient insulin efficacy/secretion,and patients are often accompanied by multiple complications.Diabetic foot is one of the most common complications of diabetes.Diabetic feet have ulcers and infections,which can eventually lead to amputation.Basic nursing care,such as lowering blood pressure and preventing foot skin infections in clinical nursing work,has positive significance for the prevention and control of diabetic feet.AIM To explore the positive significance of one-to-one education in high-risk cases of diabetic foot.METHODS This observation included 98 high-risk cases of diabetic foot in our hospital during the period from August 2017 to October 2019,and these patients were randomly divided into the basic nursing group and the one-to-one education group with 49 patients per group.The basic nursing group only received routine basic nursing,while the one-to-one education group gave patients one-to-one education on the basis of basic nursing.After nursing,the self-care ability and compliance behavior of the two groups were evaluated and compared between these two groups.The knowledge mastery of the patient and the satisfaction of nursing were accounted.RESULTS The assessment results of patients(self-care responsibility,self-care skills,selfconcept and self-care knowledge)were significantly higher in the one-to-one education group than in the basic nursing group.The scores of compliance behaviors(foot bathing,shoes and socks selection,sports health care)in the oneto-one education group were significantly higher than those in the basic nursing group.Patients in the one-to-one education group had a significantly higher level of knowledge mastery and satisfaction of nursing than the basic nursing group.CONCLUSION One-to-one education for high-risk cases of diabetic foot is helpful to improve the cognition and self-care ability of patients with diabetic foot,to ensure that patients follow the doctor’s advice of self-care and to improve their nursing satisfaction.展开更多
Indonesia is one of the top ten diabetes mellittus (DM) countries. However as the main complication of DM, there was lack of studies related to diabetic foot ulcer (DFU). Thus, the aim of this study was to survey the ...Indonesia is one of the top ten diabetes mellittus (DM) countries. However as the main complication of DM, there was lack of studies related to diabetic foot ulcer (DFU). Thus, the aim of this study was to survey the prevalence of DFU risk factors and DFU among type 2 diabetes mellitus (T2DM) patients. An epidemiological study was conducted at an outpatient endocrine clinic in a regional hospital, eastern Indonesia. All T2DM participants attending research setting that were ≥ 18 years were included. Demographic and foot care behavior were assessed using minimum data sheet (MDS). Meanwhile, presence of risk factors was evaluated by using 5.07/10 g Semmes-Weinsten Monofilament (SWM) for neuropathy and presence of angiopathy was evaluated with Ankle Brachial Index (ABI) by using a hand held Doppler (Bidop ES-100V3, Hadeco-Kawasaki, Japan) both dorsal and posterior tibialis foot. At the end of study, 249 T2DM participants were enrolled. The prevalence of DFU risk factors was 55.4% (95% CI: 53.7% - 57.0%), and prevalence of DFU was 12% (95% CI: 10.3% - 13.6%). Based on a logistic regression, predictors for DFU risk factors included age (OR: 1.04;95% CI: 1.005 - 1.074) and daily foot inspection (OR: 0.36;95% CI: 0.186 - 0.703). Meanwhile, the predictors for presence of DFU were insulin (OR: 9.37;95% CI: 2.240 - 39.182), shoes (OR: 0.05;95% CI: 0.007 - 0.294), spiritual belief that DM was a disease (OR: 0.04;95% CI: 0.004 - 0.326) and belief that DM was a temptation from God (OR: 0.13;95% CI: 0.027 - 0.598). In conclusion, we recommend to educate high risk patients to understand positive foot care behavior as essentially preventive strategies to prevent presence risk and DFU.展开更多
Objective: To apply an intensive and multidisciplinary education protocol in order to decrease, improve, delay or cancel the beginning of neuropathy and the manifestation of lesions in diabetic patients. Methodology: ...Objective: To apply an intensive and multidisciplinary education protocol in order to decrease, improve, delay or cancel the beginning of neuropathy and the manifestation of lesions in diabetic patients. Methodology: This is a cross-sectional descriptive study carried out at the Diabetes Mellitus Outpatient Clinic and Ward of Santa Marcelina Hospital in Porto Velho. This research was based on cases of patients with Diabetes and Diabetics with Leprosy. The criteria used to include the patients were: being treated with insulin therapy, not to be amputated, being on high medication of the leprosy at the moment of the evaluation and to present nutritional risk classification by the screening. The population was divided into two groups of fifteen patients: eight diabetic patients, four male and four female. Seven diabetics associated with leprosy were 4 males and 3 females. The monofilament test (Semmes-Weinstein 10 g) was used as the classification basis. Results and Discussion: Group A, called the intensive care group, began diabetes education work with medical, nutritional and rehabilitation guidelines by a multidisciplinary team for an average period of 15 days in the ward and after discharged with biweekly monitoring. Group B, called conventional care, received the same guidelines in outpatient care and the monitoring followed the quarterly protocol. Both groups were evaluated and reassessed for a period of 180 days in the outpatient clinic. Group A consisted of 8 (100%) patients, 4 (50%) diabetics and 4 (50%) diabetics and leprosy patients. Conclusion: Intensive education in diabetes showed an improvement in the sensitivity, healing and nutritional status of the patients, leading to an improvement in quality of life and disability level, reducing or delaying the beginning of neurological complications. The protocol intensive method demonstrated a 100% improvement in patients in group A.展开更多
Introduction: The term “diabetic foot” refers to all conditions that affect the foot and are directly related to the impact of diabetes. Objective: Screen the foot at risk in diabetic patients at the hospital of Mal...Introduction: The term “diabetic foot” refers to all conditions that affect the foot and are directly related to the impact of diabetes. Objective: Screen the foot at risk in diabetic patients at the hospital of Mali. Methods: It was a cross-sectional study from January 1st, 2016 to June 30, 2016, at the Department of Internal Medicine and endocrinology of the Hospital of Mali. It was focused on all hospitalized diabetic patients. Results: Thirty-two (32) patients had a foot at risk among 76 diabetic patients during the study period representing 42.10%. The sex ratio was 0.52. Type 2 diabetes accounted for 82%. A glycemic imbalance (HBA1C > 7%) was observed in 88.15%. Eighteen percent (18%) of patients had a history of ulceration or amputation;33% were walking barefoot;78.9% had tingles in the foot;31.6% had intermittent claudication;64.5% had foot cleanliness;8% claw toes;42% had abolition or reduction of superficial tenderness to monofilament and 21% had mixed foot (neuropathy + arteriopathy). In our study, 58.9% of patients had no risk of podiatry. Conclusion: Screening of foot at risk is essential in the management of diabetes because it determines the podiatric risk enabling to minimize future functional disabilities.展开更多
Background: Diabetic foot disease is a foot that exhibits any pathology that results directly from diabetic mellitus or any long-term chronic complication of diabetes mellitus. The aim of the study was to determine th...Background: Diabetic foot disease is a foot that exhibits any pathology that results directly from diabetic mellitus or any long-term chronic complication of diabetes mellitus. The aim of the study was to determine the risk factors and indications for amputations in diabetics and to correlate these risks with mortality in our environment. Patients and methods: An audit of consecutive patients who were referred and had amputation as a result of diabetic foot diseases in a tertiary institution in Sokoto, northwest Nigeria over a 2-year period was done. Parameters studied using a predetermined protocol included the bio-data, socioeconomic status, vascular status, Meggit-Wagner grading status, indications for amputation and outcome. Results: There were nineteen amputations done in 19 patients with age range of 45 to 75 years and a mean age of 57.94 ±?8.92. There were more females (68%) than males (32%) giving a M:F ratio of 1:2. Forty-one percent of patients were housewives and 89.5% were of middle socioeconomic status. Seventy-three percent of the patients had no formal education while 31.6% has had diabetes for between 6 and 10 years. All the patients had comorbidity and 78.9% were Wagner's grade V. Ascending cellulitis and sepsis (68.4%) was the commonest indication for amputation. Trans femoral amputation was carried out in 47.4% and 21.1% had reamputation. A mortality rate of 15.8% was recorded and 52.6% defaulted from follow-up. There was no correlation between the risk factors and outcome in these patients (p > 0.05). Conclusions: Amputation was commonly done in the female diabetic housewife with no formal education. Educating these patients, improving their socioeconomic status will help them modify behaviours and identify foot at risk and complications.展开更多
背景糖尿病足是糖尿病患者常见并发症,多数患者病情重,疾病进展快。性能良好的糖尿病足发病风险预测模型可以帮助医务人员识别高危患者,尽早采取干预措施。目的系统评价糖尿病足发病风险预测模型,为模型的构建和优化提供参考。方法检索P...背景糖尿病足是糖尿病患者常见并发症,多数患者病情重,疾病进展快。性能良好的糖尿病足发病风险预测模型可以帮助医务人员识别高危患者,尽早采取干预措施。目的系统评价糖尿病足发病风险预测模型,为模型的构建和优化提供参考。方法检索PubMed、Cochrane Library、Embase、Web of Science、中国知网及万方数据知识服务平台发表的关于糖尿病足风险预测模型的相关文献,检索期限为建库至2023-05-15。由研究者独立筛选文献,并提取文献数据,使用预测模型研究的偏倚风险评估工具(PROBAST)对模型进行质量评价。使用Stata 17.0软件对模型中预测因子进行Meta分析。结果共纳入13篇文献,包含13个模型,其中12个模型的曲线下面积(AUC)>0.7。7个模型进行了模型校准,8个模型进行了验证。PROBAST评估结果显示,纳入的13篇文献中有1篇为低偏倚风险,其余12篇均为高偏倚风险;模型适用性方面,1篇为低适用性。Meta分析结果显示,年龄(OR=1.13,95%CI=1.04~1.24)、糖化血红蛋白(OR=1.56,95%CI=1.26~1.94)、足溃疡史(OR=5.93,95%CI=2.85~12.37)、足截肢史(OR=7.79,95%CI=2.74~22.17)、单丝试验敏感性减弱(OR=1.59,95%CI=1.42~1.78)、足真菌感染(OR=6.14,95%CI=1.71~22.04)、肾病(OR=2.09,95%CI=1.65~2.65)是糖尿病足发病风险的影响因素(P<0.05)。结论糖尿病足风险预测模型仍存在不足,未来风险预测模型的建立可重点关注年龄、糖化血红蛋白水平、足溃疡史、足截肢史、单丝试验敏感性、足真菌感染、肾病等预测因子。展开更多
基金Supported by Medical Science and Technology Research Foundation of Guangdong Province,No.A2018461.
文摘BACKGROUND Diabetes is a common chronic disease,and its global incidence is on the rise.The disease is directly attributed to insufficient insulin efficacy/secretion,and patients are often accompanied by multiple complications.Diabetic foot is one of the most common complications of diabetes.Diabetic feet have ulcers and infections,which can eventually lead to amputation.Basic nursing care,such as lowering blood pressure and preventing foot skin infections in clinical nursing work,has positive significance for the prevention and control of diabetic feet.AIM To explore the positive significance of one-to-one education in high-risk cases of diabetic foot.METHODS This observation included 98 high-risk cases of diabetic foot in our hospital during the period from August 2017 to October 2019,and these patients were randomly divided into the basic nursing group and the one-to-one education group with 49 patients per group.The basic nursing group only received routine basic nursing,while the one-to-one education group gave patients one-to-one education on the basis of basic nursing.After nursing,the self-care ability and compliance behavior of the two groups were evaluated and compared between these two groups.The knowledge mastery of the patient and the satisfaction of nursing were accounted.RESULTS The assessment results of patients(self-care responsibility,self-care skills,selfconcept and self-care knowledge)were significantly higher in the one-to-one education group than in the basic nursing group.The scores of compliance behaviors(foot bathing,shoes and socks selection,sports health care)in the oneto-one education group were significantly higher than those in the basic nursing group.Patients in the one-to-one education group had a significantly higher level of knowledge mastery and satisfaction of nursing than the basic nursing group.CONCLUSION One-to-one education for high-risk cases of diabetic foot is helpful to improve the cognition and self-care ability of patients with diabetic foot,to ensure that patients follow the doctor’s advice of self-care and to improve their nursing satisfaction.
文摘Indonesia is one of the top ten diabetes mellittus (DM) countries. However as the main complication of DM, there was lack of studies related to diabetic foot ulcer (DFU). Thus, the aim of this study was to survey the prevalence of DFU risk factors and DFU among type 2 diabetes mellitus (T2DM) patients. An epidemiological study was conducted at an outpatient endocrine clinic in a regional hospital, eastern Indonesia. All T2DM participants attending research setting that were ≥ 18 years were included. Demographic and foot care behavior were assessed using minimum data sheet (MDS). Meanwhile, presence of risk factors was evaluated by using 5.07/10 g Semmes-Weinsten Monofilament (SWM) for neuropathy and presence of angiopathy was evaluated with Ankle Brachial Index (ABI) by using a hand held Doppler (Bidop ES-100V3, Hadeco-Kawasaki, Japan) both dorsal and posterior tibialis foot. At the end of study, 249 T2DM participants were enrolled. The prevalence of DFU risk factors was 55.4% (95% CI: 53.7% - 57.0%), and prevalence of DFU was 12% (95% CI: 10.3% - 13.6%). Based on a logistic regression, predictors for DFU risk factors included age (OR: 1.04;95% CI: 1.005 - 1.074) and daily foot inspection (OR: 0.36;95% CI: 0.186 - 0.703). Meanwhile, the predictors for presence of DFU were insulin (OR: 9.37;95% CI: 2.240 - 39.182), shoes (OR: 0.05;95% CI: 0.007 - 0.294), spiritual belief that DM was a disease (OR: 0.04;95% CI: 0.004 - 0.326) and belief that DM was a temptation from God (OR: 0.13;95% CI: 0.027 - 0.598). In conclusion, we recommend to educate high risk patients to understand positive foot care behavior as essentially preventive strategies to prevent presence risk and DFU.
文摘Objective: To apply an intensive and multidisciplinary education protocol in order to decrease, improve, delay or cancel the beginning of neuropathy and the manifestation of lesions in diabetic patients. Methodology: This is a cross-sectional descriptive study carried out at the Diabetes Mellitus Outpatient Clinic and Ward of Santa Marcelina Hospital in Porto Velho. This research was based on cases of patients with Diabetes and Diabetics with Leprosy. The criteria used to include the patients were: being treated with insulin therapy, not to be amputated, being on high medication of the leprosy at the moment of the evaluation and to present nutritional risk classification by the screening. The population was divided into two groups of fifteen patients: eight diabetic patients, four male and four female. Seven diabetics associated with leprosy were 4 males and 3 females. The monofilament test (Semmes-Weinstein 10 g) was used as the classification basis. Results and Discussion: Group A, called the intensive care group, began diabetes education work with medical, nutritional and rehabilitation guidelines by a multidisciplinary team for an average period of 15 days in the ward and after discharged with biweekly monitoring. Group B, called conventional care, received the same guidelines in outpatient care and the monitoring followed the quarterly protocol. Both groups were evaluated and reassessed for a period of 180 days in the outpatient clinic. Group A consisted of 8 (100%) patients, 4 (50%) diabetics and 4 (50%) diabetics and leprosy patients. Conclusion: Intensive education in diabetes showed an improvement in the sensitivity, healing and nutritional status of the patients, leading to an improvement in quality of life and disability level, reducing or delaying the beginning of neurological complications. The protocol intensive method demonstrated a 100% improvement in patients in group A.
文摘Introduction: The term “diabetic foot” refers to all conditions that affect the foot and are directly related to the impact of diabetes. Objective: Screen the foot at risk in diabetic patients at the hospital of Mali. Methods: It was a cross-sectional study from January 1st, 2016 to June 30, 2016, at the Department of Internal Medicine and endocrinology of the Hospital of Mali. It was focused on all hospitalized diabetic patients. Results: Thirty-two (32) patients had a foot at risk among 76 diabetic patients during the study period representing 42.10%. The sex ratio was 0.52. Type 2 diabetes accounted for 82%. A glycemic imbalance (HBA1C > 7%) was observed in 88.15%. Eighteen percent (18%) of patients had a history of ulceration or amputation;33% were walking barefoot;78.9% had tingles in the foot;31.6% had intermittent claudication;64.5% had foot cleanliness;8% claw toes;42% had abolition or reduction of superficial tenderness to monofilament and 21% had mixed foot (neuropathy + arteriopathy). In our study, 58.9% of patients had no risk of podiatry. Conclusion: Screening of foot at risk is essential in the management of diabetes because it determines the podiatric risk enabling to minimize future functional disabilities.
文摘Background: Diabetic foot disease is a foot that exhibits any pathology that results directly from diabetic mellitus or any long-term chronic complication of diabetes mellitus. The aim of the study was to determine the risk factors and indications for amputations in diabetics and to correlate these risks with mortality in our environment. Patients and methods: An audit of consecutive patients who were referred and had amputation as a result of diabetic foot diseases in a tertiary institution in Sokoto, northwest Nigeria over a 2-year period was done. Parameters studied using a predetermined protocol included the bio-data, socioeconomic status, vascular status, Meggit-Wagner grading status, indications for amputation and outcome. Results: There were nineteen amputations done in 19 patients with age range of 45 to 75 years and a mean age of 57.94 ±?8.92. There were more females (68%) than males (32%) giving a M:F ratio of 1:2. Forty-one percent of patients were housewives and 89.5% were of middle socioeconomic status. Seventy-three percent of the patients had no formal education while 31.6% has had diabetes for between 6 and 10 years. All the patients had comorbidity and 78.9% were Wagner's grade V. Ascending cellulitis and sepsis (68.4%) was the commonest indication for amputation. Trans femoral amputation was carried out in 47.4% and 21.1% had reamputation. A mortality rate of 15.8% was recorded and 52.6% defaulted from follow-up. There was no correlation between the risk factors and outcome in these patients (p > 0.05). Conclusions: Amputation was commonly done in the female diabetic housewife with no formal education. Educating these patients, improving their socioeconomic status will help them modify behaviours and identify foot at risk and complications.
文摘背景糖尿病足是糖尿病患者常见并发症,多数患者病情重,疾病进展快。性能良好的糖尿病足发病风险预测模型可以帮助医务人员识别高危患者,尽早采取干预措施。目的系统评价糖尿病足发病风险预测模型,为模型的构建和优化提供参考。方法检索PubMed、Cochrane Library、Embase、Web of Science、中国知网及万方数据知识服务平台发表的关于糖尿病足风险预测模型的相关文献,检索期限为建库至2023-05-15。由研究者独立筛选文献,并提取文献数据,使用预测模型研究的偏倚风险评估工具(PROBAST)对模型进行质量评价。使用Stata 17.0软件对模型中预测因子进行Meta分析。结果共纳入13篇文献,包含13个模型,其中12个模型的曲线下面积(AUC)>0.7。7个模型进行了模型校准,8个模型进行了验证。PROBAST评估结果显示,纳入的13篇文献中有1篇为低偏倚风险,其余12篇均为高偏倚风险;模型适用性方面,1篇为低适用性。Meta分析结果显示,年龄(OR=1.13,95%CI=1.04~1.24)、糖化血红蛋白(OR=1.56,95%CI=1.26~1.94)、足溃疡史(OR=5.93,95%CI=2.85~12.37)、足截肢史(OR=7.79,95%CI=2.74~22.17)、单丝试验敏感性减弱(OR=1.59,95%CI=1.42~1.78)、足真菌感染(OR=6.14,95%CI=1.71~22.04)、肾病(OR=2.09,95%CI=1.65~2.65)是糖尿病足发病风险的影响因素(P<0.05)。结论糖尿病足风险预测模型仍存在不足,未来风险预测模型的建立可重点关注年龄、糖化血红蛋白水平、足溃疡史、足截肢史、单丝试验敏感性、足真菌感染、肾病等预测因子。
