Methods for Diabetic Foot Disease Prevention Study

Tuesday, 14 July 2009

Karen A. Trible, MS, MSN, RN, CPN1
Dr. Mary Laurence Morgan, PhD, BSN, RN1
Jo Ann Doan, MSN, BS, RN1
Diana L. Pfannenstiel, BSN, MSN, FNP, C2
1Nursing Department, Fort Hays State University, Hays, KS
2Fort Hays State University and First Choice for Continence, Hays, KS

Learning Objective 1: identify if the intervention results in a reduction in foot-risk score in the DM2 experimental group.

Learning Objective 2: identify if the intervention results in an increased amount of reported safe foot-care practices in the DM2 experimental group.


The American Diabetes Association (ADA) describes a causal chain leading to lower-extremity amputation in the Type 2 diabetic; such as minor trauma. Plummer and Stewart (1995) state: “preventing minor trauma and subsequent non healing ulcers might interrupt this causal chain” (p. 47). A global review of the literature validates that health education can positively impact the treatment/care compliance of diabetic patients who are at high risk for peripheral vascular impairment and potential extremity amputation. A diabetes mellitus Type 2 (DM2) study investigates if education/follow up at more frequent intervals of every six weeks will positively affect the foot screening status of Type 2 diabetics and disrupt the causal chain.


Participants, diagnosed with Type 2 diabetes mellitus (DM), were recruited from the general population in central Kansas using notices in the media. Demographic data and health history/screening were recorded at baseline, using questionnaires. Participants were randomly assigned to an experimental group (N = 27) or a control group (N = 27). Members of the experimental group were contacted by phone every six weeks by a Registered Nurse (RN), who encouraged them to maintain good diabetic self-care and to attend scheduled appointments with their health care provider. care                                                                                                        


The following assessments will be made at baseline, six months, and in one year, in all participants: health of feet (ability to detect touch, vibration, heat and cold, and presence or absence of prespecified visible lesions); risk factors for diabetic vascular injury (arterial blood pressure and ankle/brachial index); and control of DM (Hb A1c percentage).


The study concludes in May, 2009; with ongoing/final statistical results available for the 20th Annual Research Congress.

Plummer, E. S., Stewart, G. A. (1995). Foot care assessment in patients with diabetes: A   screening algorithm for patient education and referral. The Diabetes Educator, 21(1), 47-51.