2012 Volume 16 Issue 3 Pages 268-277
While the importance of preventive care for diabetic foot ulcer（DFU）is recognized, there have been no reports to our knowledge detailing the specific preventive measures needed in Japan. Therefore, in this study we investigated neuropathy, angiopathy, foot deformity, history of DFU, non-ulcerative pathology and subjective symptoms in 579 diabetes patients who visited the diabetes department of a university hospital from September 2007 to March 2008. Risk was categorized based on the International Consensus on the diabetic foot, and patients’ preventive care needs such as regular inspection and examination, education, footwear, and treatment of non-ulcerative pathology were evaluated. The consultation rate at the Outpatient Foot Clinic and incidence of DFU were calculated from their medical records.
The patients' risk categories were: 0（regular inspection and examination: once a year）, 72.5%; 1（once every 6 months）, 21.3%; 2（once every 3 months）, 5.7%; and 3（every month）, 0.5%. Adaptations for education, footwear, and treatment of non-ulcerative pathology were needed in 6.2%, 31.8%, and 3.6%, respectively. The rate of consultation at the Outpatient Foot Clinic was 16% and the incidence of DFU after 36 months was 0.6%. The prevalence of tinea infection erosion was 18.5%, 15.7% had calluses, 14.4% showed dryness and 52.3% experienced cramping. Among the patients with dryness/cracking as assessed by a healthcare provider, only 45.0% were aware of their symptom.
Our results suggested that preventive care for DFU in Japan might be insufficient, because the consultation rate at the Outpatient Foot Clinic was low. More inspections by healthcare providers and preventive care for tinea infection, calluses and dryness are needed.