DOCSLIB.ORG

Influence of Diabetes- Related Knowledge on Foot Ulceration

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Influence of Diabetes- Related Knowledge on Foot Ulceration Influence of diabetes- related knowledge on foot ulceration Cynthia Formosa, Lourdes Vella Article points To investigate the relationship between diabetes-related knowledge 1. This study aimed to and foot ulceration among people with type 2 diabetes, the authors explore the relationship assessed diabetes knowledge in groups with and without foot between diabetes-related knowledge and foot ulceration. There was no significant difference in diabetes-related ulceration in a Maltese knowledge between the two groups, although the mean level of population with type 2 knowledge in the group with foot ulceration was greater. The authors’ diabetes. question current approaches to diabetes education and suggest that a 2. No significant difference new approach to diabetes education programmes is needed. in diabetes-related knowledge was found he incidence of diabetes is increasing Strine et al (2005) reported that 50–80% to exist between those worldwide and an estimated 1–4% of people with diabetes worldwide have with and without foot ulceration. T of people with type 2 diabetes significant knowledge deficits in relation to develop a foot ulcer each year (Boulton et al, the management of their condition. These 3. Diabetic foot ulcers are 2005). This is of concern for both people data suggest that people are either not a global concern leading with diabetic foot ulceration and healthcare receiving diabetes education, or that the to patient morbidity and mortality, and providers, with episodes of ulceration strongly education offered is not effective. A fuller improvements in the associated with lower-extremity amputations, understanding of the factors that contribute approach to diabetes reduced quality of life, long periods of to suboptimal self-management, leading education may improve hospitalisation and substantial healthcare ultimately to distressing and costly diabetic outcomes. costs (Boulton et al, 2005). complications, is important if improvements Key words: Research suggests that the complications in diabetes outcomes are to be achieved - Diabetes-related of diabetes – including foot ulceration (Perrin et al, 2009). knowledge – could be prevented or ameliorated by Here, the authors explore the relationship - Foot ulcer prevention long-term good glycaemic control (UK between diabetes-related knowledge and foot - Health behaviours Prospective Diabetes Study Group, 1998; ulceration in a Maltese cohort. Jabbar et al, 2001). However, optimal long- term glycaemic control requires good self- Background management and, with less than a third of Ten percent of the Maltese population people with diabetes in Europe achieving has diabetes, compared with 2–5% of the good glycaemic control (HbA1c level ≤6.5% population in its neighbouring European Cynthia Formosa is a Lecturer [≤48 mmol/mol]; Liebl et al, 2002), it has countries (Rocchiccioli et al, 2005). and the Head of the School of been suggested that people with diabetes are Expectably, foot ulceration, and ulcer Podiatry, University of Malta. not being effectively educated and supported recurrence, is common in the Maltese Lourdes Vella is a Podiatrist, to achieve good self-management. population with diabetes (Galea et al, 2009). Department of Health, Malta. The Diabetic Foot Journal Vol 14 No 2 2011 81 Influence of diabetes-related knowledge on foot ulceration Page points Aim Results 1. Participants eligible for To determine whether diabetes-related All those who met the inclusion criteria were this study were Maltese, knowledge correlated with diabetic foot invited verbally and in writing and all agreed aged >45 years with ulceration. to participate (30/30 [15 with foot ulcers; 15 type 2 diabetes with no history of foot ulceration]; 100% 2. The outcome variable Methods response rate). Both groups were matched for measured for both groups Individuals were recruited from the Diabetes age, sex, education level, duration of diabetes, was diabetes-related Podiatry Clinic, Mater Dei Hospital, Malta current medications and weight. No more knowledge, assessed by (the only public hospital in Malta). An average than a 5-year difference was accepted for age the Diabetes Knowledge Questionnaire, which was of 5000 people attend the Diabetes Podiatry or duration of diabetes for people matched in read to participants in Clinic annually, with approximately 500 the two groups. one-to-one interviews in experiencing ulceration (Mater Dei Hospital, the Maltese language. 2007). Diabetes knowledge scores 3. No significant difference Participants eligible for this study were Table 1 shows the DKQ-24 scores for each was found between the Maltese, aged >45 years with type 2 diabetes group. When comparing knowledge scores Diabetes Knowledge (World Health Organization diagnostic between the two groups, no significant Questionnaire scores of criteria; WHO, 2011). People presenting with difference was found (P=0.671). However, the two groups, however the mean score of the case an active ulcer were invited to participate as the mean DKQ-24 score of the case group group was higher than the case group; people attending for routine was higher than that of the controls (18.53 vs that of the controls. podiatry care with no history of ulceration 18.07; Table 2). were invited to participate as the control group. This study was approved by the Ethics HbA1c Board of the University of Malta. Mean HbA1c levels are shown in Table 3. No significant difference between the HbA1c Outcome measure levels of the two groups was found (P=0.312). The outcome variable measured for both groups was diabetes-related knowledge, Table 1. Comparison of Diabetes assessed by the Diabetes Knowledge Knowledge Questionnaire (DKQ-24) scores between the case and control groups. Questionnaire (DKQ-24; Garcia et al, 2001). Group DKQ-24 score, mean (SD)* This scale was developed for use in people with type 2 diabetes and is a reliable and Control (n=15) 18.07 (±0.76) valid measure that is easy to administer. Case (n=15) 18.53 (±0.78) Items include general diabetes information, *P=0.671. SD, standard deviation. urine and blood testing, diet and foot care. The DKQ-24 was read to participants in one- Table 2. Statistical analysis of the Diabetes Knowledge Questionnaire scores of the case and to-one interviews in the Maltese language control groups. (previously translated into Maltese by Formosa Between Within Total et al [2008]). groups groups As a surrogate measure of the application Sum of squares 1.633 284.667 250.300 of diabetes-related knowledge, mean HbA df 1 28 29 1c Mean square 1.633 8.881 levels of the two groups were recorded and F 0.184 compared. P-value 0.671 df, degrees of freedom. Statistical analysis Data were analysed using SPSS version 14 Table 3. Mean participant HbA1c levels. (IBM, Chicago, IL). Normality of distribution Group HbA1c, mean % (SD) was established using a Kolmogorov Smirnov Control (n=15) 7.3† (±1.3) test. One-way analysis of variance was used to Case (n=15) 7.8‡ (±1.3) determine differences in the mean. †56 mmol/mol; ‡62 mmol/mol. SD, standard deviation. 82 The Diabetic Foot Journal Vol 14 No 2 2011 Influence of diabetes-related knowledge on foot ulceration However, the mean HbA1c in the case improved glycaemic control for greater Page points group was higher than in the controls (7.8% than 3–6 months, and the prevention of 1. Previous studies on the [62 mmol/mol] vs 7.3% [56 mmol/mol]). diabetic complications (Sánchez et al, 2005; relationship between Valk et al, 2005; Mauldon et al, 2006; diabetes-related Discussion Adolfsson et al, 2007). In a systematic knowledge and diabetes This is the first study to explore the relationship review, Dorresteijn et al (2010) concluded outcomes have reported conflicting results. between diabetes-related knowledge and foot that there was insufficient evidence to ulcer prevalence in a Maltese cohort. The show that knowledge acquired through 2. In a systematic review, evidence suggests that there is no significant health education interventions reduced the Dorresteijn et al (2010) concluded that there was difference in diabetes-related knowledge incidence of diabetic foot ulceration. insufficient evidence to between people with foot ulceration and those Many of the existing diabetes education show that knowledge with no history of ulceration. programmes have been criticised for being acquired through health Previous studies on the relationship centred on knowledge and physiological education interventions between diabetes-related knowledge outcomes, and placing little importance on reduced the incidence of diabetic foot ulceration and diabetes outcomes have reported a person’s beliefs and experience of living conflicting results (Norris et al, 2002; with their condition (Sigurdardottir et al, 3. Existing diabetes Tankova et al, 2004; Valk et al, 2005; 2007). Furthermore, knowledge alone does education programmes have been criticised for Formosa et al, 2008; Dorresteijn et al; not always lead to behavioural change little importance on 2010). Few have demonstrated what (Rafique and Shaikh, 2006), while culture a person’s beliefs and might intuitively be expected; that greater is known to strongly influence behaviour experience of living with diabetes-related knowledge translates into (Lifshitz, 2006). their condition. Influence of diabetes-related knowledge on foot ulceration Page points Several studies have looked specifically at Diabetic foot health education programmes 1. Health behaviour is how culture affects the interpretation and – if they are to translate into positive complex
Load more

Recommended publications
  • Using Intervention Mapping to Develop a Digital Self-Management Program for People with Type 2 Diabetes: Tutorial on Mydesmond
    JOURNAL OF MEDICAL INTERNET RESEARCH Hadjiconstantinou et al Tutorial Using Intervention Mapping to Develop a Digital Self-Management Program for People With Type 2 Diabetes: Tutorial on MyDESMOND Michelle Hadjiconstantinou1, BSc, MSc, PhD, CPsychol; Sally Schreder2, MSc; Christopher Brough2, BSc; Alison Northern2; Bernie Stribling2, MBA; Kamlesh Khunti1, MBChB, PhD, MD, FRCGP, DCH, DRCOG; Melanie J Davies1, MB, ChB, MD, FRCP, FRCGP 1Diabetes Research Centre, University of Leicester, Leicester, United Kingdom 2Leicester Diabetes Centre, NHS Trust, University Hospitals of Leicester, Leicester, United Kingdom Corresponding Author: Sally Schreder, MSc Leicester Diabetes Centre NHS Trust University Hospitals of Leicester Gwendolen Road Leicester United Kingdom Phone: 44 116 258 4320 Email: [email protected] Abstract Digital health interventions (DHIs) are increasingly becoming integrated into diabetes self-management to improve behavior. Despite DHIs becoming available to people with chronic conditions, the development strategies and processes undertaken are often not well described. With theoretical frameworks available in current literature, it is vital that DHIs follow a shared language and communicate a robust development process in a comprehensive way. This paper aims to bring a unique perspective to digital development, as it describes the systematic process of developing a digital self-management program for people with type 2 diabetes, MyDESMOND. We provide a step-by-step guide, based on the intervention mapping (IM) framework
    [Show full text]
  • The Prediction of Clinical Outcome Using Hba1c in Acute Ischemic
    Original Article Ann Rehabil Med 2015;39(6):1011-1017 pISSN: 2234-0645 • eISSN: 2234-0653 http://dx.doi.org/10.5535/arm.2015.39.6.1011 Annals of Rehabilitation Medicine The Prediction of Clinical Outcome Using HbA1c in Acute Ischemic Stroke of the Deep Branch of Middle Cerebral Artery Sung Bong Shin, MD1, Tae Uk Kim, MD, PhD1, Jung Keun Hyun, MD, PhD1,2,3, Jung Yoon Kim, MD, PhD1,4 1Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan; 2Department of Nanobiomedical Science & WCU Research Center, Dankook University, Cheonan; 3Institute of Tissue Regeneration Engineering (ITREN), Dankook University, Cheonan; 4Ewha Brain Institute, Ewha Womans University, Seoul, Korea Objective To elucidate the association between glycemic control status and clinical outcomes in patients with acute ischemic stroke limited to the deep branch of the middle cerebral artery (MCA). Methods We evaluated 65 subjects with first-ever ischemic stroke of the deep branches of the MCA, which was confirmed by magnetic resonance angiography. All subjects had blood hemoglobin A1c (HbA1c) measured at admission. They were classified into two groups according to the level of HbA1c (low <7.0% or high ≥7.0%). Neurological impairment and functional status were evaluated using the National Institutes of Health Stroke Scale (NIHSS), Functional Independence Measure (FIM), Korean version of Modified Barthel Index (K-MBI), Korean version of Mini-Mental State Examination (MMSE-K), and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) at admission and discharge. Body mass index, serum glucose, homocysteine and cholesterol levels were also measured at admission. Results The two groups did not show any difference in the NIHSS, FIM, K-MBI, MMSE-K, and LOTCA scores at any time point.
    [Show full text]
  • Prevention of Diabetic Foot Complications
    Singapore Med J 2018; 59(6): 291-294 Commentary https://doi.org/10.11622/smedj.2018069 Prevention of diabetic foot complications Aziz Nather1, FRCSE, Shuo Cao1, Jamie Li Wen Chen1, An Yee Low1 ABSTRACT This paper discussed the importance of prevention of diabetic foot ulcers and our institution’s protocol for prevention, reviewing the existing evidence in the literature regarding the effectiveness of the preventive approach. Diabetes mellitus is the second most significant cause of disease in Singapore after ischaemic heart disease. National University Hospital, Singapore, adopts a two-pronged strategy for the management of diabetic foot ulcers. The most important strategy is prevention, and education is key. Education should mainly be directed at patients and caregivers, but also professionals (general practitioners, allied health professionals and nurses) so that they can effectively educate patients and caregivers. Patient education includes care of diabetes mellitus, care of the foot and use of appropriate footwear. Patients also tend to have poor foot hygiene. Annual foot screening for diagnosed diabetics plays an important role. However, prolonged and sustained government intervention is necessary to provide education and screening on a national scale. Keywords: annual foot screening, care of diabetes, care of foot and choice of footwear, education, prevention of diabetic foot wounds INTRODUCTION screening are required to prevent diabetic foot problems, with the Diabetes mellitus is on the rise in Singapore. It is now the second help of government intervention to run education and screening most significant cause of ill-health and disease in Singapore after programmes on a national scale. Our institution, the National ischaemic heart disease, affecting one in nine Singaporeans.
    [Show full text]
  • Type 2 Diabetes Guidelines
    Type 2 Diabetes Guidelines Version 4 Revised September 2012 for the DECENT Network Diabetes Education Care & Evaluation North of the Tees Covering the Stockton on Tees, Hartlepool and Easington areas Type 2 Diabetes Guidelines for the DECENT Network 1 NICE Diabetes in adults Quality Standards of Care 2011 1. People with diabetes and/or their carers receive a structured educational programme that fulfils the nationally agreed criteria from the time of diagnosis, with annual review and access to ongoing education. 2. People with diabetes receive personalised advice on nutrition and physical activity from an appropriately trained healthcare professional or as part of a structured educational programme. 3. People with diabetes participate in annual care planning which leads to documented agreed goals and an action plan. 4. People with diabetes agree with their healthcare professional a documented personalised HbA1c target, usually between 48 mmol/mol and 58 mmol/mol, and receive an ongoing review of treatment to minimise hypoglycaemia. 5. People with diabetes agree with their healthcare professional to start, review and stop medications to lower blood glucose, blood pressure and blood lipids in accordance with NICE guidance. 6. Trained healthcare professionals initiate and manage therapy with insulin within a structured programme that includes dose titration by the person with diabetes. 7. Women of childbearing age with diabetes are regularly informed of the benefits of preconception glycaemic control and of any risks, including medication that may harm an unborn child. Women with diabetes planning a pregnancy are offered preconception care and those not planning a pregnancy are offered advice on contraception.
    [Show full text]
  • Dynamic Hyperglycemic Patterns Predict Adverse Outcomes in Patients with Acute Ischemic Stroke Undergoing Mechanical Thrombectomy
    Journal of Clinical Medicine Article Dynamic Hyperglycemic Patterns Predict Adverse Outcomes in Patients with Acute Ischemic Stroke Undergoing Mechanical Thrombectomy 1,2, , 2,3, 4 2,5 Giovanni Merlino * y , Carmelo Smeralda y , Massimo Sponza , Gian Luigi Gigli , Simone Lorenzut 1, Alessandro Marini 2,3 , Andrea Surcinelli 2,3, Sara Pez 2,3, Alessandro Vit 4, Vladimir Gavrilovic 4 and Mariarosaria Valente 2,3 1 Stroke Unit, Department of Neuroscience, Udine University Hospital, 33100 Udine, Italy; [email protected] 2 Clinical Neurology, Udine University Hospital, 33100 Udine, Italy; [email protected] (C.S.); [email protected] (G.L.G.); [email protected] (A.M.); [email protected] (A.S.); [email protected] (S.P.); [email protected] (M.V.) 3 DAME, University of Udine, 33100 Udine, Italy 4 Division of Vascular and Interventional Radiology, Udine University Hospital, 33100 Udine, Italy; [email protected] (M.S.); [email protected] (A.V.); [email protected] (V.G.) 5 DMIF, University of Udine, 33100 Udine, Italy * Correspondence: [email protected]; Tel.: +39-043-255-2720 These authors contributed equally to this study. y Received: 5 May 2020; Accepted: 18 June 2020; Published: 20 June 2020 Abstract: Background: Admission hyperglycemia impairs outcome in acute ischemic stroke (AIS) patients undergoing mechanical thrombectomy (MT). Since hyperglycemia in AIS represents a dynamic condition, we tested whether the dynamic patterns of hyperglycemia, defined as blood glucose levels > 140 mg/dl, affect outcomes in these patients. Methods: We retrospectively analyzed data of 200 consecutive patients with prospective follow-up.
    [Show full text]
  • Meta-Analysis of Randomized Controlled Trials
    Downloaded from pmj.bmj.com on 8 September 2009 Preventing type 2 diabetes: can we make the evidence work? T Yates, M Davies and K Khunti Postgrad. Med. J. 2009;85;475-480 doi:10.1136/pgmj.2008.076166 Updated information and services can be found at: http://pmj.bmj.com/cgi/content/full/85/1007/475 These include: References This article cites 54 articles, 24 of which can be accessed free at: http://pmj.bmj.com/cgi/content/full/85/1007/475#BIBL Rapid responses You can respond to this article at: http://pmj.bmj.com/cgi/eletter-submit/85/1007/475 Email alerting Receive free email alerts when new articles cite this article - sign up in the box at service the top right corner of the article Notes To order reprints of this article go to: http://journals.bmj.com/cgi/reprintform To subscribe to Postgraduate Medical Journal go to: http://journals.bmj.com/subscriptions/ Downloaded from pmj.bmj.com on 8 September 2009 Review Preventing type 2 diabetes: can we make the evidence work? T Yates,1 M Davies,1 K Khunti2 1 Department of Cardiovascular ABSTRACT 15% of adults have prediabetes based on WHO Sciences, University of 810 2 Type 2 diabetes is associated with many serious criteria, of which an estimated 5–12% develop Leicester, UK; Department of type 2 diabetes per year.810 The risk of cardiovas- Health Sciences, University of comorbidities and is one of the leading causes of mortality Leicester, UK globally. Type 2 diabetes is preceded by a condition called cular disease is also significantly elevated with prediabetes, which is characterised by elevated glucose prediabetes.11 Given these factors, individuals with Correspondence to: concentrations resulting from peripheral and/or hepatic prediabetes will form a significant proportion of Dr T Yates, Diabetes Research the health care burden associated with diabetes in Unit, Level 1 Victoria Building, insulin resistance.
    [Show full text]
  • Secular Changes in U.S. Prediabetes Prevalence Defined by Hemoglobin
    Epidemiology/Health Services Research ORIGINAL ARTICLE Secular Changes in U.S. Prediabetes fi Prevalence De ned by Hemoglobin A1c and Fasting Plasma Glucose National Health and Nutrition Examination Surveys, 1999–2010 1 1 KAI MCKEEVER BULLARD, PHD LINDA S. GEISS, MA 199 mg/dL (impaired glucose tolerance 1 1 SHARON H. SAYDAH, PHD YILING J. CHENG, PHD 1 1 [IGT]), or hemoglobin A1c (A1C) 5.7 to GIUSEPPINA IMPERATORE, MD, PHD DEBORAH B. ROLKA, MS , , 2 1 6.5% (39 to 48 mmol/mol) (2). In CATHERINE C. COWIE, PHD DESMOND E. WILLIAMS, MD, PHD 1 1 2010, 79 million U.S. adults had predia- EDWARD W. GREGG, PHD CARL J. CASPERSEN, PHD, MPH betesbasedonIFGorelevatedA1Ccrite- ria (1). Fortunately, the Diabetes Prevention Program of the National Institutes of OBJECTIVEdUsing a nationally representative sample of the civilian noninstitutionalized U.S. population, we estimated prediabetes prevalence and its changes during 1999–2010. Health and other studies have shown that among adults with elevated glucose RESEARCH DESIGN AND METHODSdData were from 19,182 nonpregnant individ- levels, type 2 diabetes can be delayed or uals aged $12 years who participated in the 1999–2010 National Health and Nutrition Exam- prevented (3–6). Further, recent studies fi , , ination Surveys. We de ned prediabetes as hemoglobin A1c 5.7 to 6.5% (39 to 48 mmol/mol, have shown that effective lifestyle-based , A1C5.7) or fasting plasma glucose (FPG) 100 to 126 mg/dL (impaired fasting glucose [IFG]). interventions can be successfully imple- We estimated the prevalence of prediabetes, A1C5.7, and IFG for 1999–2002, 2003–2006, and – mented in community-based settings 2007 2010.
    [Show full text]
  • OBSERVATIONS Athy
    LETTERS 1 liferative or proliferative diabetic retinop- ATSUSHI MINAMOTO, PHD 3 OBSERVATIONS athy. Data are presented as means Ϯ SD. HIDEHARU FUNATSU, PHD 4 The Mann-Whitney U test was used to HIDETOSHI YAMASHITA, PHD ␣ 5 compare IL-6 and TNF- levels. To deter- SHIGEO NAKAMURA, PHD 4 mine the relationship between the sever- KEN KIRIYAMA, PHD 5 Relationship ity of periodontal disease and ETDRS, HIDEMI KURIHARA, PHD 1 retinopathy severity, or angiogenic fac- HIROMU K. MISHIMA, PHD Between Periodontal tors, as well as between X and Y parame- Disease and Diabetic ters, Spearman’s rank-order correlation Retinopathy coefficient and logistic regression model From the 1Department of Ophthalmology and Vi- were applied. sual Science, Hiroshima University Graduate School The severity of periodontal disease of Biomedical Sciences, Hiroshima, Japan; the 2De- was significantly correlated with the se- partment of Ophthalmology, Hiroshima Prefectural ecently, various studies have re- verity of diabetic retinopathy (P ϭ Hospital, Hiroshima, Japan; the 3Department of ported that periodontal disease ad- 0.0012), and the risk of proliferative dia- Ophthalmology, Diabetes Center, Tokyo Women’s Medical University, Tokyo, Japan; the 4Department versely affects diabetes (1). The betic retinopathy was significantly higher R of Ophthalmology and Visual Science, Yamagata control of periodontal disease in elderly in the presence of periodontal disease ϭ ϭ University School of Medicine, Yamagata, Japan; individuals has been reported to improve (odds ratio 2.80, P 0.036). There and the 5Department of Periodontal Medicine, Hi- the control of blood glucose (2). Severe was no significant relationship between roshima University Graduate School of Biomedical periodontal disease is associated with el- the severity of periodontal disease and Sciences, Hiroshima, Japan.
    [Show full text]
  • Designed for the Management of Adults with Diabetes Mellitus Across Wales: Consensus Guidelines
    Designed for the Management of Adults with Diabetes Mellitus across Wales: Consensus Guidelines To Support Implementation of the Diabetes National Service Framework for Wales Quality Requirements October 2008 ISBN 978 0 7504 4731 7 © Crown copyright, October 2008 CMK-12-128 D0800809 Ministerial Foreword The Welsh Assembly Government has shown commitment to people with diabetes across Wales by supporting many initiatives in the promotion and implementation of the Delivery Strategy of the National Service Framework for Diabetes in Wales. The Standards were launched in April 2002 and the Delivery Strategy in March 2003. In 2003 the estimated prevalence of diabetes across Wales was 3.8% and by 2006/7 the prevalence rate recorded from the Quality and Outcomes Framework database had increased to 4.18%. It is estimated that there are 50,000 people with diabetes who remain undiagnosed in Wales. The Delivery Strategy set the foundation for the planning and implementation of the 12 Standards of care and includes Action Plans designed to raise standards of diabetes care in Wales. Although some areas in Wales have developed their own local Management Guidelines many health professionals have requested All Wales Consensus Guidelines for the management of diabetes. The All Wales Consensus Group - health care professionals working in partnership with people with diabetes, their carers, voluntary organisations and service users - have been responsible for the development of these Guidelines designed to provide support and to improve diabetes care across Wales. Implementation of the Consensus Guidelines will assist in • the planning of services; • improved quality of services; • reducing inequalities in diabetes care across Wales.
    [Show full text]
  • The Evidence Supporting a Plant-Based Diet for Optimal Health
    The evidence supporting a plant-based diet for optimal health and prevention of chronic disease Authors: Dr Sue Kenneally, Doug Bristor, Dr Gemma Newman, Dr Alan Desmond, Dr Mahesh Shah, Dr Luke Vano, Dr Miriam Martinez-Biarge, Lucy Russell, Marta Lewandowska, Dr Shireen Kassam. Plant-based health professionals, UK (pbhp.uk) Updated April 2020 DEFINITION: A whole food plant-based diet (WFPB) is one consisting of fruits, vegetables, whole grains, legumes, nuts, seeds, with few or no animal products. Well-planned plant-based diets can support healthy living at every age and life-stage. Include a wide variety of healthy whole foods to ensure your diet is balanced and sustainable. The British Dietetic Association (BDA) INTRODUCTION: Poor diet is now the number one cause of death and disability in the UK, resulting in a rising burden of obesity, cardiovascular disease, diabetes and cancer (1). A WFPB diet has been shown to reduce the risk of these diseases, improving health and longevity (2). BENEFITS OF A WFPB DIET PATTERN Obesity and Compared to omnivores, more likely to have normal BMI and a hypertension lower BP. WFPB diet low in salt, can be as effective as NOTABLE NUTRIENTS (11) medication in lowering BP (3,4). Fibre Abundant in a WFPB diet, promoting a healthy gut ↓ ↓ Cardiovascular 30% ↓ in CVD mortality (5). WFPB can arrest and reverse microbiome, improving satiety, cholesterol, cancer. disease (CVD) atherosclerosis (6). Vitamin B12 Not made by plants or animals but microorganisms. Cancer 15% ↓ in cancer incidence and may improve survival after a Deficiency is an issue for all dietary patterns.
    [Show full text]
  • Association of Baseline Hyperglycemia with Outcomes Of
    Diabetes Volume 68, September 2019 1861 Association of Baseline Hyperglycemia With Outcomes of Patients With and Without Diabetes With Acute Ischemic Stroke Treated With Intravenous Thrombolysis: A Propensity Score–Matched Analysis From the SITS-ISTR Registry Georgios Tsivgoulis,1,2 Aristeidis H. Katsanos,1,3 Dimitris Mavridis,4,5 Vaia Lambadiari,6 Christine Roffe,7 Mary Joan Macleod,8 Petr Sevcik,9 Manuel Cappellari,10 Miroslava Nevšímalová,11 Danilo Toni,12 and Niaz Ahmed13,14 Diabetes 2019;68:1861–1869 | https://doi.org/10.2337/db19-0440 Available data from observational studies on the asso- with patients without aHG. Similarly, in the DM group, ciation of admission hyperglycemia (aHG) with outcomes patients with aHG had lower rates of 3-month favor- COMPLICATIONS of patients with acute ischemic stroke (AIS) treated with able functional outcome (mRS scores 0–1, 34.1% vs. intravenous thrombolysis (IVT) are contradictory, espe- 39.3%, P < 0.001) and FI (48.2% vs. 52.5%, P < 0.001), cially when stratified by diabetes mellitus (DM) history. higher 3-month mortality rates (23.7% vs. 19.9%, P < We assessed the association of aHG (‡144 mg/dL) with 0.001), and similar SICH rates (2.2% vs. 2.7%, P = 0.224) outcomes stratified by DM history using propensity compared with patients without aHG. In conclusion, aHG score–matched (PSM) data from the SITS-ISTR. The was associated with unfavorable 3-month clinical out- primary safety outcome was symptomatic intracranial comes in patients with and without DM and AIS treated hemorrhage (SICH); 3-month functional independence with IVT.
    [Show full text]
  • Managing Diabetic Foot Ulcers
    Review Review MANAGING DIABETIC FOOT ULCERS: BEST PRACTICE Despite a wealth of evidence and clinical guidelines, the prevention and management of diabetic foot ulcers remains a challenge. This article aims to defi ne best practice through the exploration of ten key points taken from current evidence and guidelines in an attempt to help non-specialist practitioners to implement best practice when treating patients with diabetes. Caroline McIntosh and Veronica Newton are Senior Lecturers in Podiatry, University of Huddersfi eld The need for standardised care in diabetes has been highlighted by the development of numerous clinical guidelines and best practice statements from key sources such as the National Institute for Health Figure 1. Diabetic foot and Clinical Excellence (NICE, ulcer. 2004); the Department of Health (Dept of Health, 2001); the Scottish Intercollegiate Guidelines Network, (SIGN, 2001), and the Royal College to have an appreciation of the characterised by chronic of General Practitioners underlying disease process. hyperglycaemia. (Hutchinson et al, 2000) (Table 1). New evidence is constantly Diabetes mellitus occurs when There are two main types of emerging within the field there is inadequate uptake of diabetes: type 1 and type of diabetes care, making it glucose by the cells of the body 2. In people with type 1 difficult for the non-specialist resulting in raised blood glucose diabetes, the pancreas does practitioner to remain up-to- levels (Pocock and Richards, not produce enough insulin. date with current best evidence. 2004). This is an autoimmune disease This review aims to identify the whereby the insulin producing basic requirements of diabetic Insulin, a hormone produced β-cells are destroyed by the foot examination and to define in the pancreas, regulates the body’s own immune system.
    [Show full text]