Part 6: Detection and Prevention of Foot Problems in Type 2 Diabetes
Part 6: Detection and Prevention of Foot Problems in Type 2 Diabetes Part 6: Detection and Prevention of Foot Problems in Type 2 Diabetes
Evidence Table: Section 6AuthorClinical detection of peripheral vascular diseaseLevel of EvidenceLevel Study TypeEvidenceQualityRatingMagnitudeRatingRelevanceRatingApelqvist J (1990)(Adults – Sweden)III-2 Cohort Medium High P+ HighBoyko EJ (1997)(Adults – US)III-2 Cross-sectional Medium High I+P+ HighChristensen JH (1989)(Adults – Denmark)III-2 Cross-sectional Medium Low LowElhadd TA (1999)(Adults – UK)III-2 Cross-sectional High High I-P+ HighFaglia E (1998)(Adults – Italy)III-2 Cross-sectional Medium High I- HighLehto S (1996)(Adults – Finland)III-2 Cohort High High P+ HighMcGee SR (1998)III-2Systematic review ofcohort studiesHigh High P+ LowRobertson GSM (1990)(Adults & Adolescents – III-2 Cross-sectional Low High P+ LowUK)Taniwaki H (2001)(Adults – Japan)III-2 Cross-sectional High High I+ HighWalters DP (1992)(Adults – UK)III-2 Cross-sectional High High I+ HighFor magnitude rating:+indicates positive clinical detection of peripheral vascular disease. High = clinically important & statistically significant;Medium = small clinical importance & statistically significant; Low = no statistically significant effect.Criteria for Quality and Relevance ratings are detailed in Appendix 9.52
Section 7: Diabetes Foot ProblemsIssueWhat should be the frequency of foot examination?RecommendationThe routine surveillance for foot problems in people with diabetes should be performed inthe following way:• in people without established foot problems, the minimum frequency of footexamination should be once a year• in people with at risk feet but without a current active problem, foot examinationshould be performed every 3 to 6 monthsEvidence Statements• Routine examination of the feet of people with diabetes is frequently not performedEvidence Level III-2• The optimal frequency of foot examinatin has not been established but there is generalinternational consensusEvidence Level I53
- Page 1: National Evidence Based Guidelinesf
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- Page 22 and 23: predicting risk of amputation, 2.9
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- Page 30 and 31: people with both LJM and neuropathy
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- Page 44 and 45: side; and 82% having the same resul
- Page 46 and 47: Evidence Table: Section 5Detection
- Page 48 and 49: Background - Clinical Detection of
- Page 50 and 51: pulse was bilaterally absent in 1.8
- Page 54 and 55: Background - Frequency of Foot Exam
- Page 56 and 57: Summary - Frequency of Foot Examina
- Page 58 and 59: Section 8: Diabetes Foot ProblemsIs
- Page 60 and 61: Behaviour assessment scores, measur
- Page 62 and 63: Mazzuca et al (1986) studies 532 pe
- Page 64 and 65: with before the programme, after 1-
- Page 66 and 67: Evidence Table: Section 8AuthorEffe
- Page 68 and 69: Background - Glycaemic Control and
- Page 70 and 71: In a previous Japanese randomised s
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- Page 76 and 77: period. In addition people without
- Page 78 and 79: Comparisons of in-shoe foot pressur
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- Page 82 and 83: Evidence Table: Section 10AuthorFoo
- Page 84 and 85: Background - Foot Clinics and Multi
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Evidence Table: Section 6AuthorCl<strong>in</strong>ical detection <strong>of</strong> peripheral vascular diseaseLevel <strong>of</strong> EvidenceLevel Study <strong>Type</strong>EvidenceQualityRat<strong>in</strong>gMagnitudeRat<strong>in</strong>gRelevanceRat<strong>in</strong>gApelqvist J (1990)(Adults – Sweden)III-2 Cohort Medium High P+ HighBoyko EJ (1997)(Adults – US)III-2 Cross-sectional Medium High I+P+ HighChristensen JH (1989)(Adults – Denmark)III-2 Cross-sectional Medium Low LowElhadd TA (1999)(Adults – UK)III-2 Cross-sectional High High I-P+ HighFaglia E (1998)(Adults – Italy)III-2 Cross-sectional Medium High I- HighLehto S (1996)(Adults – F<strong>in</strong>l<strong>and</strong>)III-2 Cohort High High P+ HighMcGee SR (1998)III-2Systematic review <strong>of</strong>cohort studiesHigh High P+ LowRobertson GSM (1990)(Adults & Adolescents – III-2 Cross-sectional Low High P+ LowUK)Taniwaki H (2001)(Adults – Japan)III-2 Cross-sectional High High I+ HighWalters DP (1992)(Adults – UK)III-2 Cross-sectional High High I+ HighFor magnitude rat<strong>in</strong>g:+<strong>in</strong>dicates positive cl<strong>in</strong>ical detection <strong>of</strong> peripheral vascular disease. High = cl<strong>in</strong>ically important & statistically significant;Medium = small cl<strong>in</strong>ical importance & statistically significant; Low = no statistically significant effect.Criteria for Quality <strong>and</strong> Relevance rat<strong>in</strong>gs are detailed <strong>in</strong> Appendix 9.52
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