Dara L. Eckerle Mize, MD; Gunjan Y. Gandhi, MD, MSc
Which interventions prevent foot ulcers in at-risk patients with diabetes?
Included studies evaluated interventions for primary or secondary prevention of foot ulcers in at-risk patients with diabetes.
MEDLINE (1960 to Apr 2010), Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, International Clinical Trials Registry Platform, Google databases, and reference lists of included studies and reviews were searched for published and unpublished randomized controlled trials (RCTs). 11 published studies and 1 unpublished study met the selection criteria. Studies included patients with past foot ulcers or those at high risk for foot ulcers (e.g., neuropathy plus foot deformity or amputation). Randomization was inadequate in 2 studies; the results of these studies are not reported below. Of the remaining 10 studies, 3 had adequate allocation concealment, 6 had an acceptable dropout rate, 3 used intention-to-treat analysis, 5 had blinding of providers, and none had blinding of patients.
Results of interventions to prevent foot ulcers were inconsistent (Table).
Evidence for the effectiveness of interventions to prevent foot ulcers in at-risk patients with diabetes is limited.
*NR = not reported; NS = not significant; TGAT = temperature-guided avoidance therapy; UC = usual care; other abbreviations defined in Glossary.
†1 trial reported for each comparison.
Dara L. Eckerle Mize, Gunjan Y. Gandhi. Review: Evidence for the effectiveness of interventions to prevent foot ulcers in patients with diabetes is limited. Ann Intern Med. 2011;155:JC4–8. doi: 10.7326/0003-4819-155-8-201110180-02008
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Published: Ann Intern Med. 2011;155(8):JC4-8.
Cardiology, Coronary Risk Factors, Diabetes, Endocrine and Metabolism, Prevention/Screening.
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