Repository logo
 

Podiatry

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/7

Browse

Start date: 1990Subject: search.filters.subject.Diabetes

Search Results

Now showing 1 - 5 of 5
  • Thumbnail Image
    Item
    The effect of weight reduction on the diabetes foot: A scoping review and clinical implications
    (Obesity Medicine Association, 2024-12-06) Roll Ahmed, Janine E.; Veto, John; Santos, Derek
    Background: This scoping review aims to explore the literature available on rapid weight reduction (either via diet/exercise or bariatric surgery) on the diabetes foot. Methods: A search strategy was developed using Population, Intervention, Comparison, Outcome (PICO). A search using all identified keywords and index terms was performed on Cumulated Index in Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE), PubMed, International Clinical Trials Registry Platform (ICTRP) and Web of Science (WoS) databases as well as Proquest, and Cochrane systematic reviews. A search of grey literature was also performed on Google Scholar and Internet explorer. No restrictions were placed on the date of publication. Results: There were few studies that explored the effects of weight reduction on the diabetes foot. Only 2 articles met the scoping review's inclusion criteria. These were a case study where the intervention was bariatric surgery and a case series study where the interventions were bariatric surgery or diet and exercise. Conclusion: This scoping review has highlighted the lack of research in this area, raising opportunities for further research that focus on the effects of rapid weight reduction (either following bariatric surgery or weight reduction and diet) on the diabetes foot. Patients with diabetes mellitus should receive individualised pre and post weight reduction care to their feet, either by a podiatrist or multidisciplinary care team.
  • Thumbnail Image
    Item
    The role of SmartWatch Technology in the provision of care for type 1 or type 2 Diabetes Mellitus or Gestational Diabetes: a systematic review.
    (JMIR, 2023-12-03) Alvarez, Sergio; Fellas, Antoni; Wynne, Kate; Santos, Derek; Sculley, Dean; Acharya, Shamasunder; Navathe, Pooshan; Girones, Xavier; Coda, Andrea
    Background: The use of Smart technology in the management of all forms of diabetes mellitus has grown significantly in the past ten years. Technologies such as the SmartWatch have been proposed as a method of assisting in the monitoring of blood glucose levels as well as other alert prompts such as medication adherence and daily physical activity targets. These important outcomes reach across all forms of diabetes and have the potential to increase compliance of self-monitoring with the aim of improving long term outcomes such as HbA1c. Objective: This systematic review aims to explore the literature for evidence of SmartWatch technology in type 1,2 and gestational diabetes. Methods: A systematic review was undertaken by searching Ovid MEDLINE and CINAHL databases. A second search using all identified keywords and index terms was performed on Ovid MEDLINE (January 1966 to August 2023), EMBASE (January 1980 to August 2023), Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, latest issue), CINAHL (from 1982), IEEE Xplore, and ACM Digital Libraries, and Web of Science databases. Results: Five studies were included for qualitative synthesis in this review, however, none of these studies were randomised clinical trials and published research is currently focusing on usability and feasibility. Conclusions: This systematic review has highlighted the lack of robust randomised clinical trials that explore the efficacy of SmartWatch technology in the management of patients with type 1, 2 and gestational diabetes.
  • Thumbnail Image
    Item
    Development of a prognostic model for stump healing in major lower limb amputation among the diabetic population
    (MDPI, 2021-07-12) Ashraff, Suhel; Siddiqui, Muhammad; Carline, Tom; Rush, Robert; Santos, Derek; Raza, Zahid
    Background: This study aimed to explore the effect of haematological markers as well as patient characteristics on stump healing in patients who underwent a lower limb amputation procedure. In addition, a practical model regarding factors that affected stump healing was developed. Methods: Patients who underwent a major lower limb amputation (above knee and below knee) at the Royal Infirmary of Edinburgh from the period of 2007 to 2010 were included in this study. A prognostic model utilizing backward stepwise logistical regression was developed to measure the probability of lower limb stump healing. The relationship between the dependent and independent variables was identified using univariate and multivariate logistic regression. Results: Three variables, namely serum sodium, serum creatinine and serum high density lipid cholesterol were identified which influenced stump healing. Patients with normal serum sodium were 75% more likely to have lower limb stump healing compared to that of patients with abnormal serum sodium (odds ratio [OR] 1.756; 95% confidence interval [CI] 1.048–2.942). Patients with normal serum creatinine were 66% more likely to have their stump healed (OR 1.664; 95% CI 0.94 to 2.946). The healing rate of patients with a normal level of serum high density lipid cholesterol was 75%, in contrast to patients with an aberrant level of serum high density lipids cholesterol (OR 1.753; 95% CI 1.061 to 2.895). The effectiveness of the retrospective stump-healing model was demonstrated by the area under the ROC curve (0.612), which was supported by the Hosmer and Lemeshow goodness-of-fit test (p = 0.879). Conclusions: Serum sodium, serum high density lipid cholesterol and serum creatinine have a strong correlation with lower limb stump healing. However, serum sodium and serum high density lipid cholesterol secondary to multiple co-morbidities in this cohort group could be altered secondary to disease pathology itself.
  • No Thumbnail Available
    Item
    Prediction of stump healing in lower limb amputation: A narrative review
    (Mark Allen Group, 2019-12-11) Ashraff, Suhel; Siddiqui, Muhammad A.; Santos, Derek; Carline, Tom
    Both types of diabetes, as well as different forms of acquired diabetes, are associated with diabetic peripheral neuropathy. Diabetic foot ulcers (DFU) is the condition most commonly related to somatic peripheral neuropathy, often leading to gangrene and limb amputation. Independent from large-vessel disease, sensory loss may result in DFU development and even amputation. The crucial part of any lower limb amputation is the stump healing process, which represents the central goal of postoperative management. Despite the importance attributed to this process, a standard set of guidelines regarding efficient healing methods is yet to be formulated. Health professionals are faced with the challenge of assessing the different risk factors and deciding which has a greater influence on the stump healing rate. There is currently an insufficient number of studies regarding factors effecting lower limb amputation. The main purpose of this review is to discuss the markers that can be helpful in the prediction of stump healing in patients who have undergone lower limb amputation.
  • Thumbnail Image
    Item
    Complications of Stump Healing Among Diabetic Population
    (Society of Endocrinology and Metabolism of Turkey, 2018-06-19) Ashraff, Suhel; Siddiqui, Muhammad A.; Santos, Derek; Carline, Tom
    Lower limb amputation is a major procedure performed in diabetic patients with multiple comorbidities. Almost 10% of the National Health Service budget is taken up by diabetes, with diabetes-related complications accounting for 80% of the costs. The process of wound healing is complex and involves regenerating the cellular organization and the tissue layers. Diabetics are five times more predisposed to wound infection than patients without diabetes mellitus. The amputated stump frequently becomes infected due to inadequate blood circulation, a weak immune system, and poorly controlled diabetes mellitus. Pain, stump edema, and osteomyelitis are significant complications associated with lower limb amputation wounds. A number of factors may substantiate the need for re-amputation, such as stump pain and/or phantom limb pain, delayed stump infection, the formation of symptomatic bone spurs, assessment of the skin flap designed to preserve stump length, and preparation of the stump for the prosthetic device. There are currently no reliable standards that can be referred to prior to leg amputation. The clinicians, therefore, have to rely on their judgment and investigatory parameters. The main purpose of this review is to discuss the difficulties of stump healing in the diabetic population.