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Patient education for the prevention of diabetic foot ulcers

Interim analysis of a randomised controlled trial due to morbidity and mortality of participants

  1. M Annersten Gershater RN, MNSc, PhD Student1,2,*,
  2. E Pilhammar RN, PhD Professor1,
  3. J Apelqvist MD, PhD Associate Professor2,
  4. C Alm-Roijer RN, PhD Senior Lecturer1

Article first published online: 28 NOV 2011

DOI: 10.1002/edn.189

Issue

European Diabetes Nursing

European Diabetes Nursing

Volume 8, Issue 3, pages 102–107b, September 2011

Additional Information

How to Cite

Gershater, M. A., Pilhammar, E., Apelqvist, J. and Alm-Roijer, C. (2011), Patient education for the prevention of diabetic foot ulcers. Eur. Diab. Nursing, 8: 102–107b. doi: 10.1002/edn.189

Author Information

  1. 1

    Malmö University Faculty of Health and Society, Malmö, Sweden

  2. 2

    Skåne University Hospital Department of Endocrinology, Malmö, Sweden

*Malmö University, Faculty of Health and Society, 205 06 Malmö, Sweden

Publication History

  1. Issue published online: 28 NOV 2011
  2. Article first published online: 28 NOV 2011
  3. Manuscript Accepted: 18 OCT 2011
  4. Manuscript Received: 1 AUG 2011

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References

  • 1
    International Working Group on the Diabetic Foot. International Consensus on the Diabetic Foot. Consultative Section of International Diabetes Federation, 2007.
  • 2
    International Diabetes Federation. Diabetes Education Modules. 2006.
  • 3
    American Diabetes Association. Executive Summary: Standards of Medical Care in Diabetes – 2008. Diabetes Care 2008;31(Suppl 1):S5–S11.
  • 4
    Dorresteijn J, Kriegsman D, Assendelft W, et al. Patient education for preventing diabetic foot ulceration. Cochrane Database Syst Rev 2010(5).
  • 5
    Malone J, Snyder M, Anderson G, et al. Prevention of amputation by diabetic education. Am J Surgery 1989;158:520–4.
  • 6
    Vatankhah N, Khamseh ME, Jahangiri Noudeh Y, et al. The effectiveness of foot care education on people with type 2 diabetes in Tehran, Iran. Prim Care Diabetes 2009;3:73–7.
  • 7
    Lincoln N, Radford K, Game F, et al. Education for secondary prevention of foot ulcers in people with diabetes: a randomised controlled trial. Diabetologia 2008;51:1954–61.
  • 8
    Barth R, Campbell LV, Allen S, et al. Intensive education improves knowledge, compliance, and foot problems in type 2 diabetes. Diabet Med 1991;8:111–7.
    Direct Link:
  • 9
    Bloomgarden ZT, Karmally W, Metzger MJ, et al. Randomized, controlled trial of diabetic patient education: improved knowledge without improved metabolic status. Diabetes Care 1987;10:263–72.
  • 10
    Corbett CF. A randomized pilot study of improving foot care in home health patients with diabetes. Diabetes Educ 2003;29:273–82.
  • 11
    Rönnemaa T, Hämäläinen H, Toikka T, et al. Evaluation of the impact of podiatrist care in the primary prevention of foot problems in diabetic subjects. Diabetes Care 1997;20:1833–7.
  • 12
    Kruger S GD. Foot care: knowledge retention and self-care practices. Diabetes Educ 1992;18:487–90.
  • 13
    Litzelman DK, Slemenda CW, Langefeld CD, et al. Reduction of lower extremity clinical abnormalities in patients with non-insulin-dependent diabetes mellitus: a randomized, controlled trial. Ann Intern Med 1993;119:36–41.
  • 14
    Mazzuca SA, Moorman NH, Wheeler ML, et al. The diabetes education study: a controlled trial of the effects of diabetes patient education. Diabetes Care 1986;9:1–10.
  • 15
    Williams B, Pace AE. Problem based learning in chronic disease management: A review of the research. Patient Educ Couns 2009;77:14–9.
  • 16
    Funnell MM, Brown TL, Childs BP, et al. National standards for diabetes self-management education. Diabetes Care 2011;34(Suppl 1):S89–96.
  • 17
    Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Lancet 2001;357:1191–4.
  • 18
    Wagner FW. The dysvascular foot: a system for diagnosis and treatment. Foot Ankle 1981;2:64–122.
  • 19
    Hjelm K, Nyberg P, Apelqvist J. Gender influences beliefs about health and illness in diabetic subjects with severe foot lesions. J Adv Nurs 2002;40:673–84.
    Direct Link:
  • 20
    Pecoraro RE, Reiber GE, Burgess EM. Pathways to diabetic limb amputation. Basis for prevention. Diabetes Care 1990;13:513–21.
  • 21
    Reiber GE, Smith DG, Wallace C, et al. Effect of therapeutic footwear on foot reulceration in patients with diabetes: a randomized controlled trial. JAMA 2002;287:2552–8.
  • 22
    Swedish National Diabetes Register. Questionnaire for yearly control registration. Pappersblankett [paper registration questionnaire] 2008. https://www.ndr.nu/pdf/ndr_blankett_2011.pdf.
  • 23
    Consensus Committee. Consensus statement on the worldwide standardization of the hemoglobin A1C measurement: the American Diabetes Association, European Association for the Study of Diabetes, International Federation of Clinical Chemistry and Laboratory Medicine, and the International Diabetes Federation. Diabetes Care 2007;30(9):2399–400.
  • 24
    Apelqvist J, Agardh CD. The association between clinical risk factors and outcome of diabetic foot ulcers. Diabetes Res Clin Pract 1992;18:43–53.
  • 25
    De Backer G, Ambrosioni E, Borch-Johnsen K, et al. European guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J 2003;24:1601–10.
  • 26
    Boulton AJ, Kubrusly DB, Bowker JH, et al. Impaired vibratory perception and diabetic foot ulceration. Diabet Med 1986;3:335–7.
    Direct Link:
  • 27
    Apelqvist J, Larsson J. What is the most effective way to reduce incidence of amputation in the diabetic foot? Diabetes Metab Res Rev 2000;16(Suppl 1):S75–83.
    Direct Link:
  • 28
    Gershater MA, Löndahl M, Nyberg P, et al. Complexity of factors related to outcome of neuropathic and neuroischaemic diabetic foot ulcers: a cohort study. Diabetologia 2009;52;398–407.
  • 29
    Larsson J, Agardh CD, Apelqvist J, et al. Clinical characteristics in relation to final amputation level in diabetic patients with foot ulcers: a prospective study of healing below or above the ankle in 187 patients. Foot Ankle Int 1995;16:69–74.
  • 30
    World Medical Association. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. 2008.
  • 31
    Larsson J, Agardh CD, Apelqvist J, et al. Long-term prognosis after healed amputation in patients with diabetes. Clin Orthop Relat Res 1998;(350):149–58.
  • 32
    Iversen MM, Tell GS, Riise T, et al. History of foot ulcer increases mortality among individuals with diabetes. Diabetes Care 2009;32:2193–9.
  • 33
    Apelqvist J, Larssosn J, Agardh CD. Long-term prognosis for diabetic patients with foot ulcers. J Int Med 1993;233:485–91.
    Direct Link:
  • 34
    Boyko EJ, Ahroni JH, Cohen V, et al. Prediction of diabetic foot ulcer occurrence using commonly available clinical information: The Seattle Diabetic Foot Study. Diabetes Care 2006;29:1202–7.
  • 35
    Ghanassia E, Villon L, Thuan dit Dieudonné J, et al. Long-term outcome and disability of diabetic patients hospitalized for diabetic foot ulcers. Diabetes Care 2008;31:1288–92.
  • 36
    Prompers L, Huijberts M, Apelqvist J, et al. High prevalence of ischaemia, infection and serious comorbidity in patients with diabetic foot disease in Europe. Baseline results from the Eurodiale study. Diabetologia 2007;50:18–25.
  • 37
    Tesfaye S, Boulton AJM, Dyck PJ, et al. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care 2010;33:2285–93.
  • 38
    Leksell JK, Sandberg GE, Wikblad KF. Self-perceived health and self-care among diabetic subjects with defective vision: A comparison between subjects with threat of blindness and blind subjects. J Diabetes Complications 2005;19:54–9.
  • 39
    Cavanagh PR, Bus SA. Off-loading the diabetic foot for ulcer prevention and healing. J Vascular Surgery 2010;9;52(3, Suppl 1):37S–43S.
  • 40
    National Board of Health, DACEHTA. Diabetic foot ulcers – a health technology assessment. Copenhagen: National Board for Health, Danish Centre of Health Technology Assessment (DACEHTA), 2011. Health Technology Assessment 2011; 13(2).
  • 41
    Jeffcoate W. Stratification of foot risk predicts the incidence of new foot disease, but do we yet know that the adoption of routine screening reduces it? Diabetologia 2011;54:991–3.
  • 42
    Socialstyrelsen. Nationella riktlinjer för diabetesvården 2010 – stöd för styrning och ledning. Stockholm: Socialstyrelsen; 2010. [National Board of Health and Welfare. National Guidelines for Diabetes Care 2010 – support for control and management.]
  • 43
    McInnes A, Jeffcoate W, Vileikyte L, et al. Foot care education in patients with diabetes at low risk of complications: a consensus statement. Diabet Med 2011;28:162–7.
    Direct Link:
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