Does continuation of foot self-care improve foot lesions in older patients with diabetes? A retrospective cohort study
Sayuri Sable-Morita, Keisuke Maeda, Hidenori Arai, Takuya Omura, Sumiyo Nabeshima, Yukako AndoABSTRACT
Background:
Foot lesions are a common complication in older adults with diabetes and often worsen due to sensory decline, limited mobility, and difficulty maintaining daily foot care.
Objectives:
The objective of the to clarify the association between foot self-care and improvement in foot lesions among older patients with diabetes.
Methods:
A retrospective cohort study was conducted with 160 patients aged ≥65 years having diabetes and foot lesions who were attending a diabetic foot care outpatient clinic at Hospital A in 2021.
Results:
Among 160 patients, 93 (58.1%) continued foot self-care, and 67 (41.9%) did not. Overall, 86 (53.8%) showed improvement in foot lesions after 1 year. Univariate analysis showed that years of outpatient foot care, Mini–Mental State Examination score, retinopathy and neuropathy, total number of complications, kyphosis, pain, and continuation of foot self-care were significantly associated with foot lesions (P < 0.05). Logistic regression showed that continuation of foot self-care continuation, significant variables, age, and gender as independent variables showed that the continuation of foot self-care remained significant (Odds ratio 8.33, 95% confidence interval [CI]: 3.56–19.77).
Conclusion:
Continued foot self-care was significantly associated with foot lesion improvements among older adults with diabetes, particularly among those without cognitive decline. Although causality cannot be confirmed because of the retrospective, single-center design and the wide CIs, the findings highlight the importance of sustained education and support to maintain self-care in older adults. Future multicenter studies are warranted to verify these results and develop long-term adherence strategies.