Identification of risk factors that contribute to the development of diabetic foot ulceration is very crucial as this helps in the prevention of the condition thus minimizing chances of amputations and morbidity. It has been established that diabetic peripheral neuropathy (DPN) is the main risk factor for ulceration as it increases the incidences of unconscious trauma. DPN is a common condition and one of the most prevalent long-term complications of diabetes, and studies indicate that it increases the chances of ulceration by seven-fold. The morbidity and mortality caused by diabetic foot ulcers among the diabetic population have contributed to a massive physiological, psychological, physical, and financial burden for families, patients, and the community at large since the management of DFU incur a lot of expenditure. It has also been established that diabetic foot complications/ulcers increase with age and the duration of diabetes with disregard to type, and it mainly occurs in patients above the age of 65 years. Consequently, many studies have shown a significant number of males to suffer from diabetic ulcers than females, explained on the basis that, males have low joint mobility but high foot pressure.
Comparison of research questions
A research question can either be descriptive, comparative, relationship-based, or causal types. The question of the study by Parker et al. (2019) in article 1 of the literature evaluation table is a descriptive question as it seeks a description of the effectiveness of orthotic device in managing DFU, Leila Yazdanpanah, et al. (2015)’s question seeks to describe how patient education affects their foot care and the outcomes in DFU prevention. Robert Frykberg, et al. (2016)’question is descriptive as it queries for a description of essentials of early diagnosis to the management of foot ulcerations, and Al-Rubeaan, et al. (2015)’s article is relationship-based as it seeks to establish the outcomes of an intervention i.e. outcomes of prevention programs in minimizing DFU risks. Article 5 by Estelle Everett, et al. (2018)’s is relationship-based question as it seeks to determine the relationship between the use of adjuvant therapies and effectiveness of management, article 6 is comparative question that compare management guidelines, Parker et al. (2019), and finally both questions in article 7 and 8 of the literature evaluation table are relation-based questions as they too establish the relationship between an intervention and outcome, Noha Amin, (2016) and Andrew Boulton, (2015) respectively.
Comparison of sample populations
The study samples for these research studies were mainly a review of patients’ data from previous research findings except for the study of Parker, et al. (2019) in article 1 column of the literature evaluation table, where the study was conducted at Royal Blackburn Hospital with a sample of 60 patients.
Although all the research questions aimed at investigating different topics, they all helped in building up the PICOT question for this change proposal. In other words, all the research questions helped in identifying strategies to reduce occurrences of diabetic foot ulcer in the healthcare setting. Another similarity is that all the research questions aimed at improving patient’s well being.
Comparison of limitations of the study
The limitations of the study are not properly explored in the research articles reviewed, but one clear thing is that for reliable results, every study must ensure coverage of many diabetic patients, their responses, or history files, something that seems to be laborious.
Conclusion
Diabetic foot ulcers must be effectively managed to curb the imminent danger of amputation hence morbidity, but before that, it is important to prevent the occurrence of diabetic ulcers by identifying its risk or predisposition factors. Patient education should be central to the care and prevention of DFU. Further research needs to be done to actualize the most reliable DFU management practices that are reliable and cost-effective. Consequently, extensive research is required to establish the economic impact of DFU and its complication and measures that can put in place to neutralize the impact.
References
Al-Rubeaan, K., Derwish, M. A., Ouizi, S., Youssef, A. M., Subhani, S. N., Ibrahim, H. M., & Alamri, B. N. (2015). Diabetic Foot Complications and Their Risk Factors from a Large Retrospective Cohort Study. Plos One, 10(5). doi: 10.1371/journal.pone.0124446
Amin, N., & Doupis, J. (2016). Diabetic foot disease: From the evaluation of the “foot at risk” to the novel diabetic ulcer treatment modalities. World Journal of Diabetes, 7(7), 153. doi:10.4239/wjd. v7.i7.153
Boulton, A. J. (2015). The diabetic foot. Medicine, 43(1), 33-37. doi: 10.1016/j.mpmed.2014.10.006
Everett, E., & Mathioudakis, N. (2018). Update on the management of diabetic foot ulcers. Annals of the New York Academy of Sciences, 1411(1), 153-165. doi:10.1111/nyas.13569
Frykberg, R. G., & Banks, J. (2016). Management of Diabetic Foot Ulcers: A Review. Federal Practitioner: For the Health Care Professionals of the VA, DoD, and PHS, 33(2), 16-23.
Parker, C. N., Netten, J. J., Parker, T. J., Jia, L., Corcoran, H., Garrett, M., . . . Lazzarini, P. A. (2018). Differences between national and international guidelines for the management of diabetic foot disease. Diabetes/Metabolism Research and Reviews, 35(2). doi:10.1002/dmrr.3101
Parker, D. J., Nuttall, G. H., Bray, N., Hugill, T., Martinez-Santos, A., Edwards, R. T., & Nester, C. (2019). A randomized controlled trial and cost-consequence analysis of traditional and digital foot orthoses supply chains in a National Health Service setting: Application to feet at risk of diabetic plantar ulceration. Journal of Foot and Ankle Research, 12(1). doi:10.1186/s13047-018-0311-0
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