A Delphi Study Protocol to Identify Recommendations on Physical Activity and Exercise in Patients with Diabetes and Risk of Foot Ulcerations.

Alba Gracia-Sánchez,Vicente F Gil-Guillén,Adriana López-Pineda,Esther Chicharro-Luna

doi:10.3390/ijerph182010988

Alba Gracia-Sánchez, Vicente F Gil-Guillén + Show 2 more

Open Access

https://doi.org/10.3390/ijerph182010988

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Abstract

Patients with diabetes mellitus are exposed to important complications, such as diabetic neuropathy or peripheral vascular disease. The evidence on the guidelines that these patients, with a certain risk of suffering foot ulcerations, should follow before, during and after physical exercise is scarce. The objective of this study is to identify the physical exercise guidelines to recommend based on the risk of the foot of the patient with diabetes through a consensus of experts. A three-round Delphi study will be conducted. A scientific committee (multidisciplinary group of four national experts) will review the proposal of experts and the Delphi questionnaire before submitting. A group of experts in the management and approach of the diabetic foot of an international and multidisciplinary nature will form the panel of experts, who must express their degree of (dis)agreement with each of the statements contained in the Delphi questionnaire. The percentage will be calculated in response categories, and a cut-off point of 80% will be set to define the consensus of (dis)agreement of the panelists. The results of the study could provide a series of recommendations on the realization of physical exercise in diabetic patients at risk of suffering foot ulcerations.

Highlights

Diabetes mellitus (DM), one of the most common metabolic disorders, had a global prevalence of 8.4% in adults aged 18–99 years in 2017, and it is predicted to rise to 9.9%in 2045 [1]
DM patients suffer from major complications, such as diabetic neuropathy or peripheral vascular disease [4], that can lead to diabetic foot syndrome [5]
This will be the first set of physical activity recommendations for DM patients, according to their risk of foot lesions and agreed upon by a multidisciplinary international panel

Summary

Introduction

Diabetes mellitus (DM), one of the most common metabolic disorders, had a global prevalence of 8.4% in adults aged 18–99 years in 2017, and it is predicted to rise to 9.9%in 2045 [1]. In Spain, the prevalence of type 2 DM adjusted for age and gender was. 13.8% among those aged over 18 years [2], corresponding to more than 5.3 million. Type 1 DM accounts for 1–5% of all people with diabetes [3]. According to the latest edition of the International Diabetes Federation Atlas [1], if this trend continues, by 2045, 628.6 million people aged 20–79 years worldwide will have DM. DM patients suffer from major complications, such as diabetic neuropathy or peripheral vascular disease [4], that can lead to diabetic foot syndrome [5]. Diabetic foot ulcers are among the most serious, costly, and alarming complications that compromise the survival and quality of life of patients with DM [4].

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