Author(s)

Masuko Sumikawa^1*, Yumi Kuwamura², Yasuyuki Sumikawa³, Toshiko Fujiwara⁴, Chizuru Kamiya⁵

¹Department of Nursing, School of Health Sciences, Sapporo Medical University, Sapporo, Japan.
²Department of Women’s Health Nursing, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
³Department of Dermatology, School of Medicine, Sapporo Medical University, Sapporo, Japan.
⁴Sapporo Medical University Hospital, Sapporo, Japan.
⁵Kansai University of Nursing and Health Sciences, Awaji, Japan.

PURPOSE: Diabetic patients with severe diabetic neuropathy often have hypoesthesia and numbness. This study evaluated foot self-care behavior according to severity of diabetic neuropathy. METHODS: We used a hand-held nerve conduction test device DPN check (HDN-1000, Omron) to evaluate severity of diabetic neuropathy. Foot self-care was evaluated using the Japanese SDSCA (the Summary of Diabetes Self-Care Activities measure). Foot self-care comprised visual inspection, washing, wiping interdigital areas, and checking shoes, and was scored according to the number of days self-care which was performed in the previous week. RESULTS: The study evaluated 103 diabetic patients (age: 65.7 years, diabetes duration: 13.9 years, HbA1c: 7.3%). Total scores (out of 28 points) for self-care behavior according to neuropathy severity were 11.8 (Normal: n = 54), 10.6 (Mild: n = 27), 13.3 (Moderate: n = 17), and 10.8 (Severe: n = 5). Foot self-care scores were low in all groups, with particularly low scores in those with severe neuropathy. However, no statistically significant differences were observed. CONCLUSIONS: Foot self-care is essential in diabetes because lesions are more likely to occur in severe neuropathy. Living alone and the presence of recurrent foot lesions are associated with poor survival prognosis. Accordingly, foot-care intervention must take neuropathy severity and lifestyle factors into account. The severity of diabetic neuropathy must be determined and foot-care intervention should take lifestyle factors into account.

Foot Self-Care Behavior, Diabetic Patients, Diabetic Neuropathy, Nerve Conduction Velocity, Nerve Conduction Amplitude

Sumikawa, M. , Kuwamura, Y. , Sumikawa, Y. , Fujiwara, T. and Kamiya, C. (2018) Effect of Foot Self-Care Behavior According to Severity of Diabetic Neuropathy in Japanese Patients with Diabetes. Health, 10, 1192-1199. doi: 10.4236/health.2018.109091.