Skip to content

Research at St Andrews

Preventing foot ulceration in diabetes: systematic review and meta-analyses of RCT data

Research output: Contribution to journalArticle

Author(s)

Fay Crawford, Donald Nicolson, Aparna Amanna, Angela Martin, Saket Gupta, Graham Leese, Robert Heggie, Francesca Chappell, Heather McIntosh

School/Research organisations

Abstract

Aims/hypothesis Foot ulceration is a serious complication for people with diabetes that results in high levels of morbidity for individuals and significant costs for health and social care systems. Nineteen systematic reviews of preventative interventions have been published, but none provides a reliable numerical summary of treatment effects. The aim of this study was to systematically review the evidence from RCTs and, where possible, conduct meta-analyses to make the best possible use of the currently available data.Methods We conducted a systematic review and meta-analysis of RCTs of preventative interventions for foot ulceration. OVID MEDLINE and EMBASE were searched to February 2019 and the Cochrane Central Register of Controlled Trials to October 2018. RCTs of interventions to prevent foot ulcers in people with diabetes who were free from foot ulceration at trial entry were included. Two independent reviewers read the full-text articles and extracted data. The quality of trial reporting was assessed using the Cochrane Risk of Bias tool. The primary outcome of foot ulceration was summarised using pooled relative risks in meta-analyses.Results Twenty-two RCTs of eight interventions were eligible for analysis. One trial of digital silicone devices (RR 0.07 [95% CI 0.01, 0.55]) and meta-analyses of dermal infrared thermometry (RR 0.41 [95% CI 0.19, 0.86]), complex interventions (RR 0.59 [95% CI 0.38, 0.90], and custom-made footwear and offloading insoles (RR 0.53 [95% CI 0.33, 0.85]) showed beneficial effects for these interventions.Conclusions/interpretation Four interventions were identified as being effective in preventing foot ulcers in people with diabetes, but uncertainty remains about what works and who is most likely to benefit.
Close

Details

Original languageEnglish
Pages (from-to)49-64
Number of pages16
JournalDiabetologia
Volume63
Issue number1
Early online date27 Nov 2019
DOIs
Publication statusPublished - Jan 2020

    Research areas

  • Diabetes mellitus, Evidence-based health care, Meta-analysis, Foot ulcer, Prevention, Systematic review

Discover related content
Find related publications, people, projects and more using interactive charts.

View graph of relations

Related by author

  1. The use of fibrin sealant during non-emergency surgery: a systematic review of the evidence of benefits and harms

    Edwards, S. J., Crawford, F., van Velthoven, M. H., Berardi, A., Osei-Assibey, G., Bacelar, M., Salih, F. & Wakefield, V., Jan 2017, In : Health Technology Assessment. 20, 94, 252 p.

    Research output: Contribution to journalReview article

  2. Ankle brachial index for the diagnosis of lower limb peripheral arterial disease

    Crawford, F., Welch, K., Andras, A. & Chappell, F. M., 14 Sep 2016, In : Cochrane Database of Systematic Reviews. 9, 39 p., CD010680.

    Research output: Contribution to journalReview article

  3. D-dimer test for excluding the diagnosis of pulmonary embolism

    Crawford, F., Andras, A., Welch, K., Sheares, K., Keeling, D. & Chappell, F., 5 Aug 2016, In : Cochrane Database of Systematic Reviews. 8, 46 p., CD010864.

    Research output: Contribution to journalReview article

  4. Sacubitril valsartan for treating chronic heart failure

    Edwards, S. J., Crawford, F., Osei-Assebi, G., Bacelar, M., Berardi, A. & Salih, F., 27 Apr 2016

    Research output: Book/ReportCommissioned report

Related by journal

  1. Effects of dietary and physical activity interventions on the risk of type 2 diabetes in South Asians: meta-analysis of individual participant data from randomised controlled trials

    Jenum, A. K., Brekke, I., Mdala, I., Muilwijk, M., Ramachandran, A., Kjøllesdal, M., Andersen, E., Richardsen, K. R., Douglas, A., Cezard, G., Sheikh, A., Celis-Morales, C. A., Gill, J. M. R., Sattar, N., Bhopal, R. S., Beune, E., Stronks, K., Vandvik, P. O. & van Valkengoed, I. G. M., 15 Jun 2019, In : Diabetologia. 62, 8, p. 1337-1348 12 p.

    Research output: Contribution to journalArticle

  2. Accuracy of circulating adiponectin for predicting gestational diabetes: a systematic review and meta-analysis

    Iliodromiti, S., Sassarini, J., Kelsey, T., Lindsay, R., Sattar, N. & Nelson, S., Apr 2016, In : Diabetologia. 59, 4, p. 692-699 8 p.

    Research output: Contribution to journalArticle

  3. Hospitalised hip fracture risk with rosiglitazone and pioglitazone use compared with other glucose-Lowering drugs

    Colhoun, H. M., Livingstone, S. J., Looker, H. C., Morris, A. D., Wild, S. H., Lindsay, R. S., Reed, C., Donnan, P. T., Guthrie, B., Leese, G. P., McKnight, J., Pearson, D. W. M., Pearson, E., Petrie, J. R., Philip, S., Sattar, N., Sullivan, F. M. & McKeigue, P., 1 Nov 2012, In : Diabetologia. 55, 11, p. 2929-2937 9 p.

    Research output: Contribution to journalArticle

  4. Investigation of DNA polymorphisms in SMAD genes for genetic predisposition to diabetic nephropathy in patients with type 1 diabetes mellitus

    McKnight, A. J., Woodman, A. M., Parkkonen, M., Patterson, C. C., Savage, D. A., Forsblom, C., Pettigrew, K. A., Sadlier, D., Groop, P. H., Maxwell, A. P. & Warren 3 UK GoKinD Study Grp, May 2009, In : Diabetologia. 52, 5, p. 844-849 6 p.

    Research output: Contribution to journalArticle

ID: 265462312

Top