Reducing Foot Complications for People with Diabetes - Registered ...

Reducing Foot Complications for People with Diabetes
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Recommendation • 4.0
All people with diabetes should receive basic foot care education. (Level Ib)
Recommendation • 4.1
Foot care education should be provided to all clients with diabetes and reinforced at least
annually. (Level IV)
(ADA, 2001; Apelqvist et al., 2000; Diabetes Education Study Group of the European Association for the Study of
Diabetes, 1995; Hutchinson et al., 2000; ICSI, 2000; Zangaro & Hull, 1999)
Discussion of Evidence:
Evidence supports educational intervention for improvement in foot care knowledge and
behaviour in the short term for people with diabetes (Hutchinson, et al., 2000; Valk, 2002). There is
additional evidence to support that people with diabetes who are at higher risk for foot
ulceration significantly benefit from education and regular reinforcement of that education
(ADA, 2001; CDA, 1998, 2003; Mason et al., 1999a; NHS Centre for Reviews and Dissemination, 1999; NZGG, 2000;).
The value of education is unclear for long-term prevention of foot ulceration in people with
diabetes. Reiber et al. (1992) demonstrated a three-fold increased amputation risk for those
people with diabetes who had NOT received formal diabetes education, suggesting significant
prevention is possible with appropriate teaching strategies. Nurses are well positioned to
monitor risk status and provide and/or reinforce basic foot care education, as they are the
single largest group of health professionals, working in a range of settings. They may act as
the primary diabetes foot care educator, or as a link between clients and their primary care
providers or specialized diabetes care teams.
Recommendation • 5.0
Nurses in all practice settings should provide or reinforce basic foot care education, as
appropriate. (Level IV)