The occurrence of diabetes-related foot complications, including neuropathy, infections and ulcers are escalating among people living with type 1 and type 2 diabetes in Western Australia. Foot complications may become more serious of not identified and treated early.
A recent review conducted by researchers from the University of Plymouth in England, led by Dr Joanne Paton, analysed 19 independent foot research papers to identify behaviour change interventions aimed at supporting diabetes-related footcare self-management.
More than 25 different foot self-management actions were identified – the most common being “to inspect feet daily”. Trauma avoidance and acting on warning signs were also key themes in addition to regular daily checks.
Key recommendations from the review were for intervention development to improve education and self-management for foot ulcer prevention, focussing predominantly on developing a patient’s understanding and skills to self-inspect feet and self-administer routine footcare at home. Empowering people to look after their own feet, by building their confidence and motivation, were also key factors for intervention.
Diabetes WA is working on many fronts to improve diabetes-related foot health and outcomes in Western Australia:
- FootSMART – Our regular two-hour FootSMART Workshop gives people with type 1 or type 2 diabetes skills and confidence to implement daily footcare routines, guidance on choosing the right footwear and an understanding of when to seek professional help if any foot changes ae discovered. Read more about FootSMART here.
- North Metropolitan Foot Initiative – Diabetes WA is managing the Western Australia Primary Health Alliance (WAPHA) funded, North Metropolitan Foot Initiative (NMFI) – a project focussing on a Perth hotspot which has higher than usual rates of potentially preventable hospitalisations from chronic conditions like diabetes, including a relatively high population of individuals admitted with a high-risk foot diagnosis. The aim is to determine and understand the issues that are contributing to this statistic and develop programs to provide improved outcomes.
- Kimberley Foot Camera Project – in 2019 Diabetes WA funded a number of ARANZ medical foot cameras for use by Kimberly Aboriginal Medical Services to assist remote healthcare workers photograph, measure and record diabetes-related foot ulcers and wounds during assessments. This enabled timely telehealth appointments with specialists via the internet, improving outcomes and reducing the severity of complications and number of eventual amputations. Read more here.
- Visiting a Podiatrist as part of your “Diabetes Team” – Diabetes WA recommend visiting a podiatrist regularly for routine care and inspection. Read more here.
In conclusion, some research gaps were identified during the review, and further randomised controlled trials with an extended follow up period are needed, particularly those which focus on ulcer prevention in people who have not yet developed diabetes-related foot ulceration.
Read the full research study here, published in Journal of Foot and Ankle Research in February 2021.
Cited: Joanne Paton , Sally Abey, Phil Hendy, Jennifer Williams, Richard Collings and Lynne Callaghan.