Prevention Strategy for Ulcer Recurrence in Patients with Type II Diabetes Mellitus: A Quasi-Experimental Study

Iran J Nurs Midwifery Res. 2023 Apr 14;28(2):139-143. doi: 10.4103/ijnmr.ijnmr_432_21. eCollection 2023 Mar-Apr.


Background: Many strategies exist to prevent diabetic ulcer recurrence, yet an effective method does not currently exist. This study evaluates the effectiveness of a prevention strategy to reduce ulcer recurrence in patients with Diabetes Mellitus (DM).

Materials and methods: A quasi-experimental, two group study was undertaken with 60 participants with type 2 DM. Two trained nurses participated in this study as study assistants. Participants were divided into two groups: the intervention group received preventive treatment, including examination and assessment, foot care, and an educational program; the control group received standard care using the five pillars of DM management in Indonesia.

Results: An equal number of men (n = 30) and women (n = 30) participated in this study. Neuropathy was noted in 76.70% and 56.70% of patients in the intervention and control groups, respectively. Furthermore, 63.30% of patients in the control group and 56.70% in the intervention group had foot deformities. The recurrence rate was lower in the intervention group (13.30%) than in the control group (33.30%). Moreover, 83.30% in the control group and 76.70% in the intervention group did not smoke. The duration of DM in both groups was >9 years (50% in the intervention and 43.30% in the control group). There were no significant differences between the two groups, with mean (SD) in age (t29 = -0.87, p = 0.389), ankle-brachial index (t29 = -1.05, p = 0.144), and HbA1C (t26 = -0.35, p = 0.733).

Conclusions: Prevention strategies combining examination and assessment, foot care, and educational programs can reduce ulcer recurrence in diabetic patients.

Keywords: Diabetic; foot ulcer; prevention; recurrence.