The management and prevention of diabetic foot complications: nurses’ roles

Abstract

      Foot complications in patients with diabetes are complex health problems requiring integrated care management. Nurses play crucial and diverse roles encompassing risk screening and assessment, health education and self-care skill promotion, behavior modification counseling, wound management, and interdisciplinary team coordination to ensure continuous and effective care. These complications can lead to foot ulcers, infections, and lower extremity amputations, with foot ulcer incidence rates as high as 20-30% and lower extremity amputation rates up to 8.9%, significantly impacting quality of life across physical, psychological, and economic dimensions. The primary causes of these complications stem from inadequate blood glucose control, peripheral neuropathy, and peripheral arterial disease, resulting in decreased foot sensation, impaired blood circulation, and delayed wound healing.

      This article aims to review and synthesize the essential roles of nurses in managing and preventing foot complications in patients with diabetes, focusing on five key roles: (1) systematic risk screening and foot examination, (2) health education and enhancement of self-care foot care skills, (3) counseling for behavior modification and motivation reinforcement, (4) evidence-based foot wound management, and (5) coordination with interdisciplinary healthcare teams. The effective implementation of these roles helps reduce the incidence of foot ulcers and amputations, promotes patient participation in self-care, decreases healthcare system costs, and leads to improved overall quality of life for patients with diabetes.