Prevalence Of Diabetic Foot Ulcer Research Articles

Suppression the glucose-induced ferroptosis in endothelial cells by 4OI-loading exosomes hydrogel for the treatment of diabetic foot ulcer

The prevalence of diabetic foot ulcer in individuals with diabetes is approximately 15%, and it is frequently accompanied by vascular dysfunction and infection. The management challenges make it the primary cause for amputation; however, the underlying mechanisms remain poorly understood, thereby impeding the advancement of novel wound dressings and medication. Herein, single-cell sequencing analysis revealed that ferroptosis induced by high glucose levels in vascular endothelial cells (VECs) represents a significant molecular pathological feature in diabetic foot ulcer (DFU) tissue. Furthermore, 4-Octyl itaconate (4OI) exhibited a pronounced protective effect against VECs injury induced by high glucose (HG), and its underlying molecular mechanisms involve the mitigation of HG-induced reactive oxygen species (ROS) injury and ferroptosis in VECs through the regulation Keap1/Nrf2/GPX4. For enhanced application, incubation at 37℃ was used to load 4OI into exosomes, which were subsequently encapsulated within an Alg-DA/GelMA-based hydrogel matrix. Remarkably, the utilization of 4OI-Exo-Gel not only expedited wound healing but also significantly improved the overall quality of healing in DFU. In conclusion, these findings not only demonstrate, for the first time, the remarkable ability of 4OI to enhance diabetic wound healing by mitigating VECs ferroptosis induced by HG, but also provide evidence for the potential clinical translation of a 4OI-loaded exosomes hydrogel in diabetic wound therapy.

Association between monocyte to lymphocyte ratio and diabetic foot ulcer in the population of the US with diabetes based on the 1999-2004 National Health and Nutrition Examination Survey data: a retrospective cross-sectional study.

Diabetic foot ulcer (DFU) is a severe complication that occurs in patients with diabetes and is a primary factor that necessitates amputation. Therefore, the occurrence and progression of DFU must be predicted at an early stage to improve patient prognosis and outcomes. In this regard, emerging evidence suggests that inflammation-related markers play a significant role in DFU. One such potential marker, the monocyte-lymphocyte ratio (MLR), has not been extensively studied in relation to DFU. This study aimed to define a connection between MLR and DFU. A cross-sectional study was conducted using National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2004. DFU was defined based on survey questionnaires assessing the presence of nonhealing ulcers in the lower extremities for more than 4 weeks in diabetes patients. The MLR was calculated as the ratio of the monocyte count to the lymphocyte count, which was directly obtained from laboratory data files. Logistic regression analysis was performed to assess the relationship between the MLR and DFU. Stratified analysis according to age, sex, body mass index, blood glucose, hemoglobin, and glycated hemoglobin categories was conducted, and multiple imputations were applied to missing data. In total, 1246 participants were included; the prevalence of DFU was 9.4% (117/1246). A multivariable regression model revealed a significant association between DFU and a 0.1 unit increase in MLR after adjusting for all covariates (adjusted odds ratio=1.16, 95% confidence interval: 1.02-1.33). Subgroup analyses revealed consistent findings regarding the impact of MLR on the presence of DFU (p > 0.05). MLR is significantly associated with DFU in diabetes patients, and can be used as one of the indicators for predicting the occurrence of DFU. MLR assessment may be a valuable component in the follow-up of patients with diabetes.

Prevalence of multidrug-resistant bacterial infections in diabetic foot ulcers: A meta-analysis.

Multidrug-resistant (MDR) bacterial infections have become increasingly common in recent years due to the increased prevalence of diabetic foot ulcers (DFUs). We carried out a meta-analysis aimed at investigating the prevalence of MDR bacteria isolated from DFUs and analysing the risk factors for MDR bacterial infection in patients with DFUs. The PubMed/Medline, Web of Science, Embase, Cochrane Library, Ovid, Scopus, and ProQuest databases were searched for studies published up to November 2023 on the clinical outcomes of MDR bacteria in DFUs. The main outcome was the prevalence of MDR bacteria in DFUs. A total of 21 studies were included, representing 4885 patients from which 2633 MDR bacterial isolates were obtained. The prevalence of MDR bacteria in DFUs was 50.86% (95% confidence interval (CI): 41.92%-59.78%). The prevalence of MDR gram-positive bacteria (GPB) in DFUs was 19.81% (95% CI: 14.35%-25.91%), and the prevalence of MDR gram-negative bacteria (GNB) in DFUs was 32.84% (95% CI: 26.40%-39.62%). MDR Staphylococcus aureus (12.13% (95% CI: 8.79%-15.91%)) and MDR Enterococcus spp. (3.33% (95% CI: 1.92%-5.07%)) were the main MDR-GPB in DFUs. MDR Escherichia coli, MDR Pseudomonas aeruginosa, MDR Enterobacter spp., MDR Klebsiella pneumoniae, and MDR Proteus mirabilis were the main MDR-GNB in DFUs. The prevalence rates were 6.93% (95% CI: 5.15%-8.95%), 6.01% (95% CI: 4.03%-8.33%), 3.59% (95% CI: 0.42%-9.30%), 3.50% (95% CI: 2.31%-4.91%), and 3.27% (95% CI: 1.74%-5.21%), respectively. The clinical variables of diabetic foot ulcer patients infected with MDR bacteria and non-MDR bacteria in the included studies were analysed. The results showed that peripheral vascular disease, peripheral neuropathy, nephropathy, osteomyelitis, Wagner's grade, previous hospitalization and previous use of antibacterial drugs were significantly different between the MDR bacterial group and the non-MDR bacterial group. We concluded that there is a high prevalence of MDR bacterial infections in DFUs. The prevalence of MDR-GNB was greater than that of MDR-GPB in DFUs. MDR S. aureus was the main MDR-GPB in DFUs, and MDR E. coli was the main MDR-GNB in DFUs. Our study also indicated that peripheral vascular disease, peripheral neuropathy, nephropathy, osteomyelitis, Wagner's grade, previous hospitalization, and previous use of antibacterial drugs were associated with MDR bacterial infections in patients with DFUs.

Long noncoding RNA XIST promotes cell proliferation and migration in diabetic foot ulcers through the miR-126-3p/EGFR axis

BackgroundThe prevalence of diabetic foot ulcers (DFUs) has caused serious harm to human health. To date, a highly effective treatment is lacking. Long noncoding RNA X-inactive specific transcript (lncRNA XIST) has been the subject of mounting research studies, all of which have found that it serves as a protective factor against certain diseases; however, its function in DFUs is not entirely understood. This study was performed to determine the importance of the lncRNA XIST in the pathogenesis and biological function of DFUs.MethodsDiabetic ulcer skin from rats was analysed using haematoxylin-eosin (HE), Masson’s trichrome, and immunohistochemistry (IHC) staining. The differences in the expression of genes and proteins were examined with real-time quantitative polymerase chain reaction (RT–qPCR) and Western blotting. Next, the interaction was verified with a dual luciferase gene reporter assay. In addition, CCK-8, Transwell, and wound healing assays were used to assess the proliferation and migration of HaCaT cells.ResultsThe lncRNA XIST and epidermal growth factor receptor (EGFR) were downregulated, while microRNA-126-3p (miR-126-3p) was increased in diabetic ulcer rat skin tissues and high glucose-induced HaCaT cells. In addition, we found that the lncRNA XIST binds to miR-126-3p and that EGFR is directly targeted by miR‑126‑3p. Silencing XIST contributed to upregulated miR-126-3p expression, thus lowering EGFR levels and inhibiting the proliferative and migratory abilities of high glucose-treated HaCaT cells; however, the miR-126-3p inhibitor and overexpression of EGFR reversed this effect.ConclusionDecreased lncRNA XIST expression inhibits the proliferative and migratory abilities of high glucose-induced HaCaT cells by modulating the miR-126-3p/EGFR axis, causing delayed wound healing.

Antibacterial Activity of Surfactin and Synergistic Effect with Conventional Antibiotics Against Methicillin-Resistant Staphylococcus aureus Isolated from Patients with Diabetic Foot Ulcers.

The prevalence of diabetic foot ulcers (DFUs) is increasing, leading to a huge financial burden and human suffering. Furthermore, antibiotic resistance is an urgent problem in the realm of clinical practice. Antimicrobial peptides are an effective and feasible strategy for combating infections caused by drug-resistant bacteria. Therefore, we investigated the in vitro antimicrobial ability of the lipopeptide surfactin, either alone or in combination with conventional antibiotics, against the standard and clinical strains of Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA), isolated from patients with DFUs. The minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of surfactin on the selected strains were evaluated by a microbroth dilution technique. The growth curves of the selected strains with and without surfactin were measured, and transmission electron microscopy was used to observe the structure of surfactin-treated bacterial cells. The biofilm inhibitory abilities of surfactin were assessed by crystal violet staining. The antimicrobial interactions between surfactin and conventional antibiotics were established using a checkerboard assay, as well as determining the mutant prevention concentration. The inhibitory effect of surfactin on penicillinase was tested by iodometry. The MIC and MBC values of surfactin ranged from 512 to 1024 µg/mL and 1024 to 2048 µg/mL, respectively. Moreover, surfactin significantly prevented the S. aureus biofilm formation and displayed limited toxicity on human red blood cells. The synergies between surfactin and ampicillin, oxacillin, and tetracycline against S. aureus were revealed. In vitro resistance was not readily produced by surfactin. The action of surfactin may be by disrupting bacterial cell membranes and inhibiting penicillinase. Surfactin appears to be a potential option for the treatment of DFUs infected with MRSA, as it is capable of improving antimicrobial activities and can be used alone or in combination with conventional antibiotics to prevent or postpone the emergence of resistance.

Comparison of customized vacuum sealing drainage and vacuum sealing drainage in the treatment of diabetic foot ulcers: a retrospective analysis

BackgroundThe prevalence of diabetic foot ulcers, a common, more serious chronic diabetes-related complication, is increasing. Vacuum sealing drainage (VSD) constitutes an effective adjunctive treatment for diabetic foot ulcers. Factors, such as poor glycemic control, ischemia, and infection prolong wound healing time, and VSD products are expensive and unaffordable for many patients.ObjectiveTo compare the use of customized VSD and customized VSD in the treatment of diabetic foot ulcer.MethodThis retrospective study included 83 patients with diabetic foot ulcers in customized VSD (n = 44) and VSD (n = 39) groups. Baseline data, efficacy after 14 days, total treatment efficiency, final outcome (28 days after treatment, healing rate), average treatment cost, and hospitalization (days) of the two groups were compared. Factors affecting wound healing were analyzed.ResultsNo significant intergroup differences in the baseline data were detected (VSD vs. customized VAD, p > 0.05). Treatment efficacy was higher in the customized VSD group than in the VSD group after 14 days (p < 0.05), although total treatment efficiency in both groups reached 100%. The final outcome in the customized VSD group was better (vs. VSD group, p < 0.05), and the wound healing rate was higher than in the VSD group (66.7% vs. 33.3%). The mean treatment cost and hospital days were greater in the VSD group (vs. customized VSD group; p < 0.05). Factors affecting wound healing include age, Wagner classification, HDL-C, and fasting C-peptide. Younger age, low Wagner classification grade, low HDL-C level, and high fasting C-peptide contribute to higher healing rate,ConclusionEfficacy and final outcome of customized VSD were better than that of VSD; the customized VSD device is simple and convenient to operate, and enables cost-effective treatment.

Bacterial profile and antimicrobial resistance patterns of infected diabetic foot ulcers in sub-Saharan Africa: a systematic review and meta-analysis

The number of diabetic foot ulcer patients is substantially increasing, with the rapidly rising burden of diabetic mellitus in sub-Saharan Africa. The data on the regional prevalence of diabetic foot ulcer infecting bacteria and their antimicrobial resistance patterns is crucial for its proper management. This systematic review and meta-analysis determined the pooled prevalence of bacterial profiles and antimicrobial resistance patterns of infected diabetic foot ulcers in sub-Saharan Africa. A comprehensive search of the literature was performed on CINAHL, EMBASE, Google Scholar, PubMed, Scopus, and Web of Science databases. Critical appraisal was done using the Joanna Briggs Institute’s tool for prevalence studies. A pooled statistical meta-analysis was conducted using STATA Version 17.0. The I2 statistics and Egger’s test were used to assess the heterogeneity and publication bias. The pooled prevalence and the corresponding 95% confidence interval of bacterial profiles and their antimicrobial resistance patterns were estimated using a random effect model. Eleven studies with a total of 1174 study participants and 1701 bacteria isolates were included. The pooled prevalence of the most common bacterial isolates obtained from DFU were S. aureus (34.34%), E. coli (21.16%), and P. aeruginosa (20.98%). The highest pooled resistance pattern of S. aureus was towards Gentamicin (57.96%) and Ciprofloxacin (52.45%). E.coli and K. Pneumoniae showed more than a 50% resistance rate for the most common antibiotics tested. Both gram-positive and gram-negative bacteria were associated with diabetic foot ulcers in sub-Saharan Africa. Our findings are important for planning treatment with the appropriate antibiotics in the region. The high antimicrobial resistance prevalence rate indicates the need for context-specific effective strategies aimed at infection prevention and evidence-based alternative therapies.

Prevalence of diabetes foot ulcers and associated factors among adult diabetic patients in three referral hospitals in Mogadishu, Somalia.

Diabetes mellitus (DM) causes significant morbidity and mortality in sub-Saharan Africa (SSA), including Somalia. Among diabetic patients, diabetic foot ulcers (DFUs) constitute the largest proportion of admissions, amputations, and mortality. The aim of this study is to assess the prevalence of diabetic foot ulcers and subsequently determine factors associated with it among diabetic patients at three major hospitals in Somalia. An institutional-based cross-sectional study was conducted among 193 diabetic patients between August and November 2022. All eligible diabetes patients who were attending De Martini Hospital, Madina General Hospital, and Deynile General Hospital during the study period were included in the study. Patients were interviewed using a structured questionnaire. We collected demographic, clinical, and behavioral variables from all participants. A bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. An odds ratio with a 95% confidence interval was computed to determine the level of significance. The mean age of the study's participants was 50.9 ± 13.6 years. The prevalence of diabetic foot ulcer was 15%. Patients who were either overweight or obese (OR 4.63, CI: 2.08-10.30), had a lack of family support in managing diabetes (OR 3.33, CI: 1.74-6.36), and did not check their feet regularly were more likely to develop DFU (OR 1.99, CI:1.08-3.66). Increased body mass index, lack of family support, and not checking feet regularly were associated with DFUs. The high prevalence of DFUs and the plethora of needs of people with DFUs pose challenges for health care. A coordinated health care system is necessary to meet the needs of diabetic patients and prevent DFUs.

A 15-year follow-up report of an elderly diabetic foot with multiple recurrences leading to toe amputation and thoughts on the model of care for diabetic foot ulcer.

Diabetic foot ulcer (DFU) is one of the most serious complications of diabetes. Elderly diabetic patients are a high prevalence of diabetic foot ulcers, and their high recurrence, disability, and mortality rates impose a heavy economic burden on families and society. This paper reports a case of an elderly patient with a diabetic foot ulcer who was admitted in April 2007 and discharged after recovery from comprehensive diabetic foot treatment. Due to intermittent foot care and lack of home care, the patient's foot ulcers recurred after repeated healing during home rehabilitation, eventually resulting in the amputation of the right bunion. After the patient was discharged from the hospital with an amputated toe, the whole-process seamless management model of "hospital - community - family" was implemented. The hospital provides specialized foot support and guidance, and the community is responsible for daily disease management and referrals. The family is responsible for the implementation of home rehabilitation programs, and family caregivers need to identify and provide feedback on foot abnormalities promptly. As of May 2022, the patient had not experienced ulcer recurrence. This paper reports the whole process of "ulcer development → ulcer healing → ulcer recurrence healing → toe amputation → continuous care management" experienced by the patient in 15 years, aiming to reflect on the significance of the whole-process seamless foot care management model of "hospital-community-family" for diabetic foot ulcer rehabilitation through the case.

Diabetic Foot Ulcer (DFU) Gene Expression in Homo Sapiens Species

Diabetic foot ulcer (DFU) is a major problem in people with diabetes because more than 15% of patients have to treat DFU during their lifetime. 1 out of people with diabetes can experience a diabetic foot ulcer (DFU). At least a quarter of diabetic foot ulcer (DFU) sufferers cannot recover completely. The prevalence of diabetic foot ulcers (DFU) in Indonesia reaches 8.7%. The current DFU treatment approved by the FDA uses Becaplermin, a recombinant platelet-derived growth factor derivative. However, this treatment has a weakness in systemic bioavailability. FAgene expression analysis method is needed. to develop other therapies. This article aims to discover specific genes that play a role in diabetic foot ulcer (DFU) wound healing. In this systematic review, we searched the GEO Data Sets database to identify articles published from 2018 to 2023. The search results for DFU gene expression data for all species obtained 130 articles. Then, the DFU gene expression data series of Homo sapiens species was filtered to obtain ten related articles. This research has implications in providing better insight into the specific genes involved in the healing process of DFU wounds. This research also has the potential to contribute to early diagnosis of DFU injuries and better treatment.

Prevalence of diabetic foot ulcers and assessment of foot care knowledge and practice among patients attending diabetic clinic of a tertiary hospital of eastern India

Background: Diabetic foot ulcer (DFU) is a dreaded complication holding huge health and socio-economic impacts and negative impacts on quality of life of individual, community and society as a whole yet carrying scope of preventive potential. The objectives were to find out the prevalence of diabetic foot ulcers and to assess gap in knowledge, foot care practices and their determinants. Methods: A cross-sectional study was conducted over three months among 310 diabetic outpatients of a medical college of an eastern Indian state. Data were collected with a validated questionnaire containing socio-demographics, clinical and behavioral factors, foot care knowledge and practice and SINBAD score was used for assessing diabetic ulcers. Results: Out of 310 participants, 44 (14.2%) had diabetic foot ulcer and 1/5th of them had SINBAD score ≥3 indicating severity. Knowledge level was poor among 245 (79.0%) and healthy foot habits were among only 70 (22.6%). Addiction, diabetes for ≥5 years, any associated non-communicable diseases, irregular treatment and follow-up care, unhealthy foot condition, improper foot wear, poor knowledge of the disease and unhealthy foot habits had significant association with occurrence of foot ulcers. Conclusions: Generation of awareness can bring about prevention of development of foot ulceration among diabetic patients and henceforth can avert risk of adverse consequences of it.

Prevalence of diabetic foot ulcer and its associated factors among diabetes patients on follow up at public hospitals in West Shewa Zone, Oromia, Ethiopia”

ObjectivesDiabetes mellitus (DM) is a growing health problem today. Diabetic foot ulceration (DFU) is the devastating complication. There is very limited information currently available in this regard at study area. Hence, in this study, we aimed to assess Prevalence and Associated Factors with diabetes foot ulcer among Diabetes Patients on Follow-up at Public Hospitals in West Shewa Zone, Oromia, Ethiopia. A facility-based cross-sectional study was conducted from March to June 2021 and a systematic random sampling method used to recruit study participants. A total of 4,807 diabetics are under observation. Among these proportionally allocated sample hospitals, Ambo University Referral Hospital, Ambo General Hospital, Guder Hospital and Gedo General Hospital were 1700, 1507, 600 and 1000 respectively. Data were collected by the interviewer using structured questionnaires from the study participants. Epi data version 3.1.1 and SPSS version 25 were used for data entry and analysis respectively. Descriptive statistics followed by multivariable logistic regression analysis were performed. Both crude and adjusted odds ratios and 95% confidence intervals CIs were reported. ResultsThe Prevalence of diabetes foot ulcers in this study was 18.7% (95%; CI 14.1 23.3). Marital status {AOR: 3.46; 95% CI:(1.41, 8.48), P = 0.007}, Diabetes peripheral neuropathy {AOR: 4.30, 95% CI:(1.67, 11.10), P = 0.002} and deformity {AOR: 17.546, 95% CI: (6.95, 44.3), P = 0.000} were significant determinants for the development of diabetes foot ulcer. Thus, health care providers are recommended to thoroughly give emphasis during follow-up of patients with identified factors to decrease the occurrence of diabetes foot ulcers.

Hubungan ESBL dengan Lama Rawat Inap pada Pasien Ulkus Kaki Diabetes

Diabetic Foot Ulcer (DFU) is a condition of foot ulcers caused by neuropathy disorders. The prevalence of DFU in Indonesia is around 15% with an amputation rate of 30% and a mortality rate of 32%. DFU is known as a chronic wound with a long healing time. Infection with Extended-Spectrum Beta-Lactamase (ESBL) is an important predictor in determining the optimal antibiotic regimen. The study aim was to determine the association between ESBL infection with length of stay in DFU patients at Abdoel Wahab Sjahranie Hospital, Samarinda. This study used analytical observational method with a cross-sectional study approach. The research data were gathered from the medical records of DFU patients at Abdoel Wahab Sjahranie Hospital Samarinda from the period of 2020–2022 with a purposive sampling method. There were 108 patients selected as samples through inclusion and exclusion criteria. The statistical bivariate analysis was performed using Chi-Square test. The results showed that there was no association between ESBL (p=0.676) towards length of stay in DFU patients at Abdoel Wahab Sjahranie Hospital Samarinda.&#x0D;

1742. Antibiotic Use in the Podiatry Clinic: Antimicrobial Stewardship Setting Foot in Uncharted Territory

Abstract Background Podiatrists independently manage diabetic foot ulcers (DFU), often complicated by diabetic foot infections (DFIs). The prevalence of DFU is 40 - 60% and guidelines vary in their recommendations for DFI, creating a target for antimicrobial stewardship. However, the prevalence and appropriateness of antibiotics prescribed by podiatrists has not been reported. We describe both variables among patients with DFU in a podiatry clinic. Methods We conducted a retrospective chart review of all consecutive patients &amp;gt; 18 years of age with DFUs, infected or not, who had at least one visit to the UPMC Mercy Wound Clinic (Pittsburgh, PA) in 2020. We defined severity of infection using the PEDIS score and diagnosis of osteomyelitis (OM) (Figure 1). We collected data on antibiotics prescribed by podiatry in the clinic or by any provider during a hospitalization for DFI. Figure 2 shows our appropriateness criteria. Figure 1:Stratification of Severity of Diabetic Foot InfectionFigure 2:Criteria for Appropriateness of Antibiotic Use in Diabetic Foot Ulcers Results Of 72 patients with DFU, 32 (44.4%) received an antibiotic. Compared to those who did not receive antibiotics, patients who did were more likely male (86.2% vs. 63.6%), had a higher PEDIS score (2.03 vs. 1.49), and were more frequently diagnosed with OM (71.9% vs. 26.8%). (Table 1). Table 2 shows the most common antibiotics. Among the five patients with no to mild infection, none received appropriate treatment (Table 3). Two patients in that category received IV antibiotics (when hospitalized for DFI), and neither received an Infectious Diseases (ID) consult. The other three were considered inappropriate due to durations &amp;gt; 7 days. The mean length of treatment for patients with mild infection was 12.6 (4.56). The two patients with moderate infection who received antibiotics had “inappropriate” courses; however, both had complicated Staphylococcus aureus bacteremia, and therefore 4-6 weeks courses were justified. All 12 inappropriate courses in severe infections were due to courses &amp;gt; 42 days. Conclusion Prescription of antibiotics among patients with DFU was common. Our findings suggest potential targets for antimicrobial stewardship: unnecessarily long courses an IV antibiotic use in patients with mild or no infection. Our criteria can be refined to recognize situations in which prolonged therapy may be justified, and larger studies are warranted. Disclosures All Authors: No reported disclosures.

Advantages of Metformin Therapy for Diabetic Foot Ulcer Prevention and Mitigation

Introduction: Diabetes foot is one of the most common complications of diabetes. Metformin treatment may aid in lowering the prevalence of diabetic foot ulcers in diabetic patients. Study objectives: The purpose of this study was to look into the prevalence of diabetic foot ulcers among diabetic patients attending out-patient, as well as the impact of metformin treatment on the development of diabetic foot ulcers. Methodology: To collect data from diabetic patients' files, a retrospective design was used. Demographic variables such as gender and age were included in the study, as well as clinical variables such as diabetes duration, metformin treatment, and diabetic foot ulcer status. Data was gathered and entered into SPSS version 20 for analysis. Descriptive features of statistical analysis included frequency, percentage, mean, and standard deviation. Various statistical models, such as the Chi-square test, One Way Anova, and Pearson's correlation, were used to investigate the relationship between variables. If p 0.05, the significance was accepted. Results: The study included 62 diabetic patients with an average age of 56.9511.98 years. The males were 33 (53.2%), the duration of diabetes was 7.55.86 years, metformin was prescribed to approximately 66% of patients, the mean metformin dose was 1617.32649.49 mg, and the prevalence of DF was 8.1%. There were no significant relationships between DF and gender or metformin use (p&gt;0.05). Both the One-Way Anova Test and the correlation test revealed that DF was significantly related to DF. Conclusion: The current study found that metformin treatment is significantly associated with metformin dose and could protect diabetic patients from developing DF.

Diabetic Foot Ulcers: Prevalence and Associated Risk Factors Among Diabetic Patients

Diabetes Mellitus, a complex disease, chronic in nature; requires uninterrupted care to reduce various risk factors beyond glycemic control. Objective: To find out prevalence of foot ulcers among diabetic patients and identification of risk factors that can lead to the development of ulcers among diabetic patients attending the tertiary care centers of Faisalabad. Methods: A cross sectional survey was conducted on 500 diabetic patients attending the diabetic clinics. Subjects were identified using non-probable convenient sampling and data was collected by using structured questionnaire. Associated risk factors of diabetic foot ulcers were all assessed. Using SPSS version 23.0 for windows software, data were managed and analyzed. Results: There were n=239 males and n=261 females. Most of the patients were in the age group of 61-70. Major population belonged to middle socio-economic status (46.2%). Diabetic foot ulcer prevalence was 10.4%. There was significant association between ulcer and age (p=.036), gender (p&lt;.001), lifestyle of patient (p=.003), BMI of Patient (p=.001), smoking habits (p&lt;.001), duration of diabetes (p&lt;.001), and family history of diabetes (p&lt;.001). Conclusions: The study concluded that 10.4% of diabetic patients had foot ulcers. Diabetic foot ulceration was significantly related with male gender. It is thus recommended that diabetic care providers can reduce the prevalence of diabetic foot ulcers by increasing understanding of the disease and foot care examination among those having sensory loss.

The Effect of Diabetic Foot Exercises on Ankle Brachial Index Values and the Degree of Diabetic Foot Risk in Diabetes Melitus Patients

Background: The prevalence of Diabetic Foot Ulcers (DFU) in diabetics is 4-10% where this condition more often affects the elderly. DFU is a serious marker of a disease that if optimal prevention is not carried out from the start, the wound deteriorates rapidly, and the worst is amputation. Diabetic foot exercises are used as leg exercises and are beneficial in reducing pain, reducing nerve damage, controlling blood sugar and increasing blood circulation in the feet. The purpose of this study was to analyze the effect of diabetic foot exercise on the degree of risk of diabetic foot ulcers and the Ankle brachial index value in Diabetes Mellitus patients in the Work Area of the Mamboro Health Center. Methods: This type of research is quasi-experimental with a one group pretest posttest design. The sample is 16 people. The instruments used were a monofilament test, sphygmomanometer, stethoscope, and an instrument for assessing the risk of diabetic foot. Data analysis used is paired t test and Wilcoxon test. Results The results showed that diabetic foot exercise had an effect on changes in the value of blood circulation (ABI) with a p value (0.000) and a score of degrees of risk of diabetic foot with a p value (0.001). Conclusion of this study is that diabetic foot exercise has a statistical effect on both the ABI value and the diabetic foot degree score. Suggestions from this study are that nurses more often conduct DM foot exercise education in an effort to prevent DFU

The prevalence of foot ulcers in diabetic patients in Pakistan: A systematic review and meta-analysis.

We aimed to determine the pooled prevalence of diabetic foot ulcers in Pakistan. MEDLINE (PubMed), Web of Science, Google scholars, and local databases were systematically searched for studies published up to August 10, 2022, on the prevalence of foot ulcers among diabetic patients in Pakistan. Random-effects meta-analysis was used to generate summary estimates. Subgroup analysis and meta-regression models were used to address the issue of high heterogeneity. Two authors independently identified eligible articles, collected data, and performed a risk of bias analysis. Twelve studies were included in the meta-analysis (14201, range 230-2199, diabetic patients), of which 7 were of "high" quality. The pooled prevalence of diabetic foot ulcers was 12.16% (95% CI: 5.91-20.23%). We found significant between-study heterogeneity (I2 = 99.3%; p < 0.001) but no statistical evidence of publication bias (p = 0.8544). Subgroup meta-analysis found significant differences in foot ulcer prevalence by publication year and by the duration of diabetes. An increasing trend was observed during the last two decades, with the prevalence of diabetic foot ulcers being the highest in the latest period from 2011 to 2022 (19.54%) than in the early 2000 s (4.55%). This study suggests that the prevalence of diabetic foot ulcers in Pakistan is relatively high, with significant variation between provinces. Further study is required to identify ways for early detection, prevention, and treatment in the population.

Prevalences of diabetic foot ulcer and foot self-care practice, and associated factors in adult patients with diabetes in south-east Ethiopia.

ObjectiveWe aimed to assess the prevalences of foot ulcer and foot self-care practices, and identify associated factors in adult patients with diabetes attending a referral hospital in south-east Ethiopia.MethodsWe performed a cross-sectional study of 267 diabetic patients. Multivariable binary logistic regression was used to identify factors associated with diabetic foot ulcer and foot self-care practice.ResultsThe prevalence of diabetic foot ulcer was 11.2% (95% confidence interval [CI] 7.42–15.05). One hundred and forty-four (53.9%; 47.9, 59.9) patients demonstrated good foot self-care. Living rurally (adjusted odds ratio 2.27; 95% CI: 1.86–6.97), lack of regular exercise (3.91; 1.51–10.10), peripheral neuropathy (2.77; 1.05–7.33) and foot calluses (5.69; 1.74–18.59) were associated with diabetic foot ulcer. Urban inhabitants (2.01; 1.09–3.69), patients with diabetes for >10 years (2.92; 1.48–5.77), women (2.95; 1.66–5.22), and patients with a glucometer at home (2.05; 1.09–3.85) were more likely to have good foot self-care practice.ConclusionThe prevalence of diabetic foot ulcer was 11.2%. This prevalence is lower than those identified in other Ethiopian studies. However, patient awareness regarding foot self-care practice and risk reduction should be improved.

Nursing students’ knowledge and attitude toward diabetic ulcer care and their contributing factors in Indonesia

ObjectiveThe prevalence of diabetic foot ulcer in Indonesia is far greater than the global prevalence. Nursing students are expected to have good knowledge and positive attitudes regarding diabetic ulcer care in order to deliver high-quality wound care during clinical practice. This study aimed to assess nursing students’ knowledge and attitudes toward diabetic ulcer care and to investigate the factors related to them. MethodsA cross-sectional study was conducted on 396 academic and clinical phases in three nursing schools in Indonesia from September 2021 to February 2022. Participants completed a survey including a questionnaire about knowledge and attitudes regarding diabetic ulcer care. The data were analyzed using a Chi-square test and multivariate logistic regression analysis. ResultsThe results show that 43.2% (171/396) of nursing students had inadequate knowledge of diabetic ulcer care. However, 88.9% (352/396) had a favorable attitude toward the topic. Nursing students lacked knowledge about the characteristics of diabetic ulcers, diabetic neuropathy, wound infection, and adjunctive therapy for diabetic ulcers, and many of them believe that diabetic ulcer care is too time-consuming to carry out. Students in the clinical phase of their studies had significantly better knowledge than those in the academic phase (aOR = 9.99, 95% CI 4.96–20.08, P < 0.001). Male nursing students were significantly less likely to have positive attitude toward the topic than female students (aOR = 0.42, 95% CI 0.19–0.96, P = 0.048), and students accustomed to sharing with peers as a source of knowledge had better attitudes than those who were not (aOR = 2.76, 95% CI 1.40–5.41, P = 0.003). ConclusionFindings show that almost half of the nursing students have insufficient knowledge of diabetic ulcer care. Curriculum developers and educators need to improve the curriculum regarding diabetic wound care and provide strategic programs to improve students’ knowledge and attitudes based on the factors discovered in this study.