Relationship between level of education and podiatry risk in diabetic patients

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Ramla Mizouri
Maha Belhadj
Yosra Hasni
Amel Maaroufi
Faten Mahjoub
Henda Jamoussi

Abstract

Context: Diabetic foot trophic disorders and their complications leading to the risk of amputation remain a major public health problem.
Objective: To determine the level of podiatric risk in our diabetic patients according to the classification of the International Working Group of the Diabetic Foot (IWGDF) and study the relationship between the level of education and the level of podiatry risk..
Methods: This is a descriptive and analytical cross-sectional study including all diabetics hospitalized at the National Institute of Nutrition in Tunis for chronic diabetes imbalance, carried out over a period of two months (July - August 2019).
Results: The mean age of the patients was 55.08 ± 14.22 years. The sex ratio was 0.67. The majority of our patients were type 2 diabetics (90.24%). During the clinical examination of the foot, plantar hyperkeratosis was the most noted manifestation (65.85%). Based on the IWGDF classification, 42.68% of patients had a grade 0 podiatric risk. Regarding the overall educational level, we noted 76.83% patients with a poor educational level and 23.17% patients with a satisfactory level of education. The overall educational level is significantly associated with the podiatric grade (p <0.05).
Conclusions: Therapeutic education or even podiatric education of the patient is important in the prevention of complications of the foot. Patient-centered training in foot care practice in public health facilities would reduce the rate of morbidity and mortality from complicated diabetic foot.

Keywords:

Diabetic foot - Podiatry risk - Therapeutic education

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References

  1. Références : 1. Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 1 avr 2018;138:271‑81. 2. WHO | Country and regional data on diabetes [Internet]. WHO. [cité 1 déc 2019]. Disponible sur: https://www.who.int/diabetes/facts/world_figures/en/index5.html 3. Apelqvist J, Bakker K, van Houtum WH, Nabuurs-Franssen MH, Schaper NC. International consensus and practical guidelines on the management and the prevention of the diabetic foot. International Working Group on the Diabetic Foot. Diabetes Metab Res Rev. oct 2000;16 Suppl 1:S84-92. 4. Schaper NC, Netten JJV, Apelqvist J, Lipsky BA, Bakker K. Prevention and management of foot problems in diabetes: a Summary Guidance for Daily Practice 2015, based on the IWGDF Guidance Documents. Diabetes Metab Res Rev. 2016;32(S1):7‑15. 5. Chicharro-Luna E, Pomares-Gómez FJ, Ortega-Ãvila AB, Coheña-Jiménez M, Gijon-Nogueron G. Variability in the clinical diagnosis of diabetic peripheral neuropathy. Prim Care Diabetes [Internet]. 14 juin 2019; 6. Bus SA, van Netten JJ, Lavery LA, Monteiro-Soares M, Rasmussen A, Jubiz Y, et al. IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes. Diabetes Metab Res Rev. janv 2016;32 Suppl 1:16‑24. 7. Mold JW, Vesely SK, Keyl BA, Schenk JB, Roberts M. The prevalence, predictors, and consequences of peripheral sensory neuropathy in older patients. J Am Board Fam Pract. oct 2004;17(5):309‑18. 8. Pirart J. [Diabetes mellitus and its degenerative complications: a prospective study of 4,400 patients observed between 1947 and 1973 (3rd and last part) (author's transl)]. Diabete Metab. déc 1977;3(4):245‑56. 9. Diabetic Patients' Knowledge and Practice Regarding Prevention of Diabetic Foot [Internet]. [cité 24 nov 2019]. Disponible sur: http://medicaljournalofcairouniversity.net/home2/index.php/2014-10-22-23-17-21/vol-81-march-2013/1078-diabetic-patients-knowledge-and-practice-regarding-prevention-of-diabetic-foot 10. Young MJ, Boulton AJ, MacLeod AF, Williams DR, Sonksen PH. A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population. Diabetologia. févr 1993;36(2):150‑4. 11. Papanas N, Ziegler D. Risk Factors and Comorbidities in Diabetic Neuropathy: An Update 2015. Rev Diabet Stud RDS. Spring-Summer 2015;12(1‑2):48‑62. 12. Ziegler D, Papanas N, Vinik AI, Shaw JE. Epidemiology of polyneuropathy in diabetes and prediabetes. Handb Clin Neurol. 2014;126:3‑22. 13. Yagihashi S, Mizukami H, Sugimoto K. Mechanism of diabetic neuropathy: Where are we now and where to go? J Diabetes Investig. 24 janv 2011;2(1):18‑32. 14. Mustafa A, Iqbal M, Parvez MA. Assessment of Knowledge, Attitude Practices of Diabetics Regarding Their Foot Care. APMC 2017;(1):43-47. 15. Muhammad-Lutfi AR, Zaraihah MR, Anuar-Ramdhan IM. Knowledge and Practice of Diabetic Foot Care in an In- Patient Setting at a Tertiary Medical Center. Malays Orthop J. 2014 Nov;8(3):22-6. 16. Yazidi M, Chaker F, Chihaoui M, Slimane. Pratique des soins des pieds chez les diabétiques à haut risque podologique dans un centre hospitalo-universitaire. H.Educ Ther Patient. 2015 ; 7 :20104. 17. Goweda R, Shatla M, Alzaidi A, Alzaidi A, Aldhawani B, et al. Assessment of Knowledge and Practices of Diabetic Patients Regarding Diabetic Foot Care, in Makkah, Saudi Arabia. Journal of Family Medicine and Health Care. Vol. 3, No. 1, 2017, pp. 17-22. 18. Carlesso GP, Gonçalves MHB, Moreschi Júnior D, Carlesso GP, Gonçalves MHB, Moreschi Júnior D. Evaluation of diabetic patients' knowledge about preventive care of the diabetic foot, in Maringá, PR, Brazil. J Vasc Bras. juin 2017;16(2):113‑8. 19. Beck J, Greenwood DA, Blanton L, Bollinger ST, Butcher MK, Condon JE, et al. 2017 National Standards for Diabetes Self-Management Education and Support. Diabetes Educ. févr 2018;44(1):35‑50. 20. Liang YJ, Ran XX. [Interpretation of the management of diabetic foot in national guideline for the prevention and control of diabetes in primary care (2018): early screening and standardized care]. Zhonghua Nei Ke Za Zhi. 1 nov 2019;58(11):842‑4. 21. IDF Congress 2017: Scientific programme. Diabetes Res Clin Pract. 2017;133:214‑6. 22. Pinzur MS, Slovenkai MP, Trepman E, Shields NN, Diabetes Committee of American Orthopaedic Foot and Ankle Society. Guidelines for diabetic foot care: recommendations endorsed by the Diabetes Committee of the American Orthopaedic Foot and Ankle Society. Foot Ankle Int. janv 2005;26(1):113‑9. 23. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 12 janv 2005;293(2):217‑28. 24. Litzelman DK, Slemenda CW, Langefeld CD, Hays LM, Welch MA, Bild DE, et al. Reduction of lower extremity clinical abnormalities in patients with non-insulin-dependent diabetes mellitus. A randomized, controlled trial. Ann Intern Med. 1 juill 1993;119(1):36‑41. 25. Mason J, O'Keeffe C, McIntosh A, Hutchinson A, Booth A, Young RJ. A systematic review of foot ulcer in patients with Type 2 diabetes mellitus. I: prevention. Diabet Med J Br Diabet Assoc. oct 1999;16(10):801‑12. 26. Valk GD, Kriegsman DMW, Assendelft WJJ. Patient education for preventing diabetic foot ulceration. A systematic review. Endocrinol Metab Clin North Am. sept 2002;31(3):633‑58. 27. Patout CA, Birke JA, Horswell R, Williams D, Cerise FP. Effectiveness of a comprehensive diabetes lower-extremity amputation prevention program in a predominantly low-income African-American population. Diabetes Care. sept 2000;23(9):1339‑42.