Evaluation of the relationship among foot wound risk, foot self-care behaviors, and illness acceptance in patients with type 2 diabetes mellitus

Inflammation-Responsive Hydrogel Accelerates Diabetic Wound Healing through Immunoregulation and Enhanced Angiogenesis

Angiogenesis is a prominent component during the highly regulated process of wound healing. The application of exogenous vascular endothelial growth factor (VEGF) has shown considerable potential in facilitating angiogenesis. However, its effectiveness is often curtailed due to chronic inflammation and severe oxidative stress in diabetic wounds. Herein, an inflammation-responsive hydrogel incorporating Prussian blue nanoparticles (PBNPs) is designed to augment the angiogenic efficacy of VEGF. Specifically, the rapid release of PBNPs from the hydrogel under inflammatory conditions effectively alleviates the oxidative stress of the wound, therefore reprogramming the immune microenvironment to preserve the bioactivity of VEGF for enhanced angiogenesis. In vitro and in vivo studies reveal that the PBNPs and VEGF co-loaded hydrogel is biocompatible and possesses effective anti-inflammatory properties, thereby facilitating angiogenesis to accelerate the wound healing process in a type 2 diabetic mouse model.

Association between effect of acceptance of illness and medication adherence, metabolic control, and risk of diabetic foot in individuals with diabetes

AIMS

This study aimed to determine the association between the level of acceptance of illness and medication adherence, metabolic control, and risk of diabetic foot in patients with diabetes.

METHODS

This descriptive study was conducted with 298 patients with diabetes. The questionnaire comprised the demographic characteristics of the patients, Modified Morisky Scale and the Acceptance of Illness Scale. The study data were collected by the researchers through direct interviews using the questionnaire.

RESULTS

Acceptance of illness in patients with diabetes was statistically significantly higher in the group with a higher level of knowledge of medication adherence (p < 0.001). Moreover, the acceptance of illness had a statistically significant negative correlation with fasting plasma glucose (r = -0.198; p < 0.001) and glycated hemoglobin (r = -0.159; p = 0.006) levels in individuals with diabetes. Levels of acceptance of illness had a statistically significant association with the risk of diabetic foot (p < 0.01).

CONCLUSIONS

The study found that the level of acceptance of illness was associated with the level of knowledge about medication adherence, metabolic control, and risk of diabetic foot in individuals with diabetes. It may be recommended to conduct clinical trials to determine the effect of evaluating the level of acceptance of the illness on diabetes management and to increase this level.

Effect of a Podiatric Health Education Intervention on the Level of Self-care in Patients with Diabetes Mellitus

OBJECTIVE

To test the effect of a podiatric health education activity on foot self-care and the degree of foot-related disability in a group of people with diabetes mellitus (DM) in the province of Seville. A pretest-posttest quasi-experimental design was used.

METHODS

Twenty-nine people with DM participated. The intervention was a podiatric health education activity consisting of a 1-hour informative talk. Foot pain-related disability was measured using the Manchester Foot Pain and Disability Index. The degree of foot self-care was measured with the University of Malaga Foot Self-care questionnaire.

RESULTS

One month after the intervention, both parameters had improved significantly. The mean score on the Manchester Foot Pain and Disability Index increased from 59.96 (SD, 8.69) at baseline to 67.39 (SD, 6.99) at 1 month, and the mean score on the University of Malaga Foot Self-care questionnaire improved from 11.65 (SD, 20.07) at baseline to 4.52 (SD, 5.47) after 1 month.

CONCLUSIONS

Therapeutic education increases the level of self-care and decreases the degree of foot-related disability in people with DM.

Design and Development of a Mobile-Based Self-Care Application for Patients with Type 2 Diabetes

INTRODUCTION

Mobile-based applications play a leading role in changes in life-style, improve medication adherence, and provide a unique opportunity to aid patients with type 2 diabetes mellitus (T2DM) elevate their healthcare level. Therefore, we aim to design and develop a mobile-based self-care application for patients with T2DM.

METHODS

The present study was an applied and developmental study to design and develop a mobile-based self-care application for people living with T2DM conducted in 2020. The design and development of the T2DM self-care application were done in 2 main phases of determining the key features and capabilities, and design and development of the T2DM self-care mobile app.

RESULTS

We identified the main model and a set of capabilities and features for the T2DM self-care application. By content analysis on 32 different applications and a previous study by the author, 18 features were extracted for the T2DM self-care mobile app. JAVA programming languages were used to design T2DM applications. Moreover, because of the cost-effectiveness, the Android operating system (AOS) was selected as a platform, and because of the widespread use of smartphones; these phones were chosen as the format of T2DM self-care application.

CONCLUSIONS

In this study, we design and develop a mobile-based self-care application for patients with type 2 diabetes that shows potential in solving the shortcomings of mobile apps for diabetes care. By utilizing the T2DM self-care mobile app we are able to deploy a self-care application with a wide range of functionality such as text messaging, blood glucose monitoring, insulin dose suggestions, educational messaging, metabolic management, pedometer counts, and reporting. Future studies are needed to develop self-care applications for a different type of diabetes with different functions of diabetes care.

An estimation of diabetes foot self-care based on validated scores: A systematic review and meta-analysis

A diabetic foot ulcer is a preventable complication of diabetes, which could lead to lower extremity amputation and increased mortality and morbidity. Self-care behaviors play a key role in the prevention of diabetic foot ulcers. This study aimed to estimate the total score of diabetic foot self-care behaviors. We searched databases such as Web of Science, Medline (PubMed), and Scopus using various keywords, including diabetic foot, diabetic feet, diabetic problem, diabetic foot ulcer, and self-care, for relevant articles with no time limit. The heterogeneity of the studies was assessed using Cochran's Q test and I² statistic. Data were analyzed using STATA software version 12 using the meta-analysis method and a random effects model. In total, eight studies were analyzed with a sample size of 2,493. The pooled score of diabetes foot self-care was 62.84% and this score was higher in the studies conducted on two groups of patients with type I and type II diabetes compared to those performed only on patients with type II diabetes. The results also indicated correlation between the self-care score and year of publication (P < 0.001), and the self-care scores significantly declined during 2015-2021 (P < 0.001). Overall, the diabetic foot self-care score was moderate, which highlights the need to provide self-care education to diabetic patients.