Department of Nursing, University of Valencia, Valencia, Spain
Frailty Research Organized Group, University of Valencia, Valencia, Spain
Endocr Metab Immune Disord Drug Targets. 2020;20(9):1365-1372. doi: 10.2174/1871530320666200128154036.
Diabetic foot syndrome (DFS) is a common long-term complication of diabetes mellitus. DFS has recently been associated with adverse effects that could further impair the quality of life of diabetic patients, and increase the social and economic burden, morbidity, and premature mortality of the disease. The main physio-pathological basis of DFS is due to diabetesinduced neuropathy and angiopathy in the lower limbs and feet. Patients diagnosed with DFS must significantly modify their daily habits in order to cope with signs and symptoms of DFS and this can alter their quality of life. The objective of this review is to summarize the evidence regarding the economic, physical and social limitations which can affect the quality of life (QoL) in patients with DFS, the effects of ulcers and amputations on QoL outcomes.
Different aspects related to DFS such as physical alterations, psychological complaints and even disorders, socio-economic difficulties can affect the quality of life of these patients. However, the QoL related to low socio-economic factors gave mixed results and physical activity, education and type of footwear can influence the outcomes. There is a general gender-dependent higher prevalence of DFS in men, although it depends on the geographical area. DFS often co-occurs with other diabetes-induced complications (retinopathy, nephropathy and cardiovascular disorders) and comorbid obesity generally worsens it.
Accessibility to health services aimed at reducing inequalities and constant health education and promotion and care regarding psychological and socio-economic issues should be continuously undertaken for individuals with DFS in order to improve their QoL.
糖尿病足综合征(DFS)是糖尿病的一种常见长期并发症。最近,DFS 与可能进一步损害糖尿病患者生活质量的不良影响相关联,并增加疾病的社会和经济负担、发病率和过早死亡率。DFS 的主要生理病理学基础是由于糖尿病引起的下肢和足部的神经病变和血管病变。被诊断患有 DFS 的患者必须显著改变他们的日常生活习惯,以应对 DFS 的体征和症状,这可能会改变他们的生活质量。本综述的目的是总结与影响 DFS 患者生活质量(QoL)的经济、身体和社会限制相关的证据,以及溃疡和截肢对 QoL 结果的影响。
DFS 相关的不同方面,如身体改变、心理投诉甚至障碍、社会经济困难,都会影响这些患者的生活质量。然而,与低社会经济因素相关的 QoL 结果喜忧参半,身体活动、教育和鞋类类型都可以影响结果。男性中 DFS 的总体患病率较高,尽管这取决于地理位置。DFS 常与其他糖尿病引起的并发症(视网膜病变、肾病和心血管疾病)同时发生,肥胖症等合并症通常会使其恶化。
为了提高 DFS 患者的生活质量,应该持续提供旨在减少不平等的医疗服务,并不断进行心理健康教育、促进和关注心理和社会经济问题。