Cited by 56Diabetic Foot Ulcer Assessment and ManagementSkin Diseases and DiabetesFoot and Ankle Surgery

Meta‐analyses of randomized controlled trials reporting the effect of home foot temperature monitoring, patient education or offloading footwear on the incidence of diabetes‐related foot ulcers

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Alahakoon, C., Fernando, M., Galappaththy, C., Matthews, E. O., Lazzarini, P., Moxon, J. V., Golledge, J.·2020·Diabetic Medicine

Abstract

Aim: The aim of this study was to perform an up‐to‐date systematic review and meta‐analysis of randomized controlled trials (RCTs) examining the efficacy of home foot temperature monitoring, patient education and offloading footwear in reducing the incidence of diabetes‐related foot ulcers. Methods: A literature search was performed using MEDLINE, PubMed, CINAHL, Scopus and Cochrane databases to identify relevant original studies. Meta‐analyses were performed using intention‐to‐treat principals for worst (main analysis) and best (sub‐analysis) case scenarios. Leave‐one‐out sensitivity analyses were used to assess the consistency of findings. Results: Of 7575 unique records, 17 RCTs involving 2729 participants were included. Four tested home foot temperature monitoring (n = 468), six examined patient education (n = 823) and seven assessed offloading footwear (n = 1438). Participants’ who performed home foot temperature monitoring [odds ratio (OR) 0.51, 95% confidence interval (CI) 0.31 to 0.84;n = 468] and those provided offloading footwear (OR 0.48, 95% CI 0.29 to 0.80;n = 1438) were less likely to develop a diabetes‐related foot ulcer. Patient education programmes did not significantly reduce diabetes‐related foot ulcer incidence (OR 0.59, 95% CI 0.29 to 1.20;n = 823). Sensitivity analyses suggested that offloading footwear findings were consistent, but home foot temperature findings were dependent on the individual inclusion of one trial. All RCTs had either high or unclear risk of bias. Conclusion: This meta‐analysis suggests that offloading footwear is effective in reducing the incidence of diabetes‐related foot ulcers. Home foot temperature monitoring also appears beneficial but larger trials are needed (PROSPERO registration no.: CRD42019135226).

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Crossref · 10.1111/dme.14323

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Authors
Alahakoon, C., Fernando, M., Galappaththy, C., Matthews, E. O., Lazzarini, P., Moxon, J. V., & Golledge, J.
Affiliations
  • University of Peradeniya (LK)
  • Australian Institute of Tropical Health and Medicine (AU)
  • Ulcer and Wound Healing Consortium (UHEAL) Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry Townsville Australia
  • Queensland University of Technology (AU)
  • Townsville Hospital (AU)
Corresponding author
Golledge, J.
Venue
Diabetic Medicine
Publisher
Wiley
Published
2020-06-08
Volume
37
Issue
8
Pages
1266-1279
ISSN
  • 0742-3071 (ISSN-L)
  • 1464-5491
OpenAlex
W3027516941
Cited by
56
References
67
Citations by year
2026: 4 · 2025: 4 · 2024: 10 · 2023: 11 · 2022: 14 · 2021: 11 · 2020: 2
FWCI
1.45
Type
journal article
Language
en
Open access
Locations
  • Diabetic Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • QUT ePrints (Queensland University of Technology) (submittedVersion, cc-by-nc)
  • ResearchOnline at James Cook University (James Cook University) (submittedVersion)
Funders
  • James Cook University
  • Queensland Government
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
  • Health Sciences › Medicine › Dermatology › Skin Diseases and Diabetes
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Foot and Ankle Surgery
Keywords
diabetic foot ulcer, patient education, ulcer prevention, diabetes complications, foot care
MeSH terms
Body Temperature, Foot, Humans, Patient Education as Topic, Self Care, Shoes, Odds Ratio, Randomized Controlled Trials as Topic, Weight-Bearing, Diabetic Foot

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