Risk of ulceration in people with diabetes mellitus and factors associated with adherence to self-care.
Danielle Mendonça Oliveira, Giovanna Lanna Araújo Carvalho, Laura Andrade Pinto and 5 others
PMID 42615778WHAT IT FOUND
The overall self-care score was not linked to foot ulcer risk among 769 people with diabetes, and adherence was low.
Longer diagnosis time, more visits, and taking five or more medicines related to better testing or medication taking, but links were small.
Key findings
01Among 769 participants, median self-care score was 17.66 on a 105-point scale, and 44.1% had foot ulceration risk.
02The overall self-care score was not associated with foot ulceration risk (p=0.157).
03Several clinical factors, including visit frequency, diagnosis time, polypharmacy, and professional foot examination, were associated with self-care scores, but effect sizes were small (<0.50).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Because it was cross-sectional, it cannot show that self-care causes lower ulcer risk or that any factor changes risk. The sample came only from urban Family Health Strategy units in one municipality, so results may not apply to rural areas or other places. People under 18 years and those unable to answer questionnaires were excluded, so it does not describe those groups. The associations with self-care scores were statistically significant but had small effect sizes, so they explain only a small part of adherence. The self-care questionnaire did not fit the study sample well on some standard checks, so the scale's dimensions should be interpreted cautiously. It did not measure family support, access barriers, cognition, or emotional state, which may affect self-care.
Declared interests
Funding was provided by the Minas Gerais Research Support Foundation (APQ-00765-21 and APQ-04289-22). The supplied text does not state commercial conflicts.
The easy way to misread this
Do not conclude that better self-care lowers ulcer risk. The overall self-care score was not associated with foot ulceration risk (p=0.157), and the study cannot show cause and effect.