Insufficient evidence for patient education in preventing diabetic foot ulceration

January 01, 0001

Insufficient evidence for patient education in preventing diabetic foot ulceration

Clinical Question: How effective is patient education in preventing diabetic foot ulceration?

Bottom line: Bottom line There was little evidence to support the effectiveness of patient education for the prevention of diabetic foot ulceration or amputations. One randomised controlled trial (RCT) with good methodological quality showed limited patient education did not result in any beneficial effect on these primary outcomes. PatientsÕ foot care knowledge was improved in the short term (one to six months) in five of eight RCTs in which this outcome was assessed, as was patientsÕ self-reported self-care behaviour in the short term (six to 18 months) in seven of nine RCTs. The effects on callus, nail problems and fungal infections were described in five of the included studies, of which only two reported temporary improvements after an educational intervention. The effectiveness of more comprehensive and/or more intensive educational programmes, however, remains to be investigated further.

Caveat: Most of the RCTs included in this review were at high or unclear risk of bias. Only one of the included RCTs was considered to be at low risk of bias. Follow-up ranged from four weeks to seven years, with a median of six months.

Context: Foot ulcers are common in people with diabetes, especially those with peripheral neuropathy and/or peripheral vascular disease. They affect 15% to 25% of people with diabetes at some time in their lives. Foot ulcers not only lead to physical disability and loss of quality of life but also impose a significant economic burden (healthcare costs, industrial disability).

Cochrane Systematic Review:Dorresteijn JAN et al. Patient education for preventing diabetic foot ulceration. Cochrane Reviews, 2010, Issue 5. Article No. CD001488. DOI: 10.1002/14651858.CD001488. pub3. This review contains 11 studies involving over 2710 participants.

Cochrane PEARLS Practical Evidence About Real Life Situations. No. 276, August 2010. .
Written by Brian R McAvoy. Published by the Cochrane Primary Care Group

Category: T. Endocrine/Metabolic/Nutritional. Keywords: diabetes mellitus type 2, foot ulcer, prevention, patient eduation
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 23 November 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care

To obtain Pearls directly, sign up here for the english language version

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.