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Non-pharmacological interventions to improve cardiovascular risk factors in people with diabetic foot disease: A systematic review and meta-analysis

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posted on 2024-03-14, 11:27 authored by Patrick Highton, Abdullah Almaqhawi, Maroria Oroko, Harini Sathanapally, Laura Gray, Melanie Davies, David Webb, Frances Game, John Petrie, Solomon Tesfaye, Jonathan Valabhji, Clare Gillies, Kamlesh Khunti
Cardiovascular disease (CVD) risk in those with diabetic foot disease is very high. Non-pharmacological interventions may improve this risk, though no previous evidence synthesis has been completed. This systematic review aimed to investigate the impact of non-pharmacological interventions on CVD risk factors in diabetic ulcer disease. Multiple databases and trials registers were searched from inception to December 6th 2023. We included reports of randomised controlled trials investigating the impact of non-pharmacological interventions on cardiovascular risk in those with type 1 or type 2 diabetes and current or previous diabetic foot disease. Twenty studies were included. Extracted data included: study design and setting; participant sociodemographic factors; and change in cardiovascular risk factors. Data were synthesised using random effects meta-analyses and narrative syntheses. Interventions included nutritional supplementation, collaborative care, hyperbaric oxygen therapy, patient education, nurse-led intervention, self-management, family support, relaxation and exercise, over a median duration of 12 weeks. Significant post-intervention changes were observed in fasting plasma glucose, serum insulin levels, insulin sensitivity and resistance, glycated haemoglobin, triglycerides, total cholesterol, low-density lipoprotein-cholesterol and C-reactive protein. No effects were detected in very low- or high-density lipoprotein-cholesterol or body mass index. Non-pharmacological interventions show promise in improving CVD risk in diabetic foot disease.

Funding

Developing and Evaluating A Multifactorial Intervention to Improve Cardiovascular Outcomes in Adults with Type 2 Diabetes and Current or Previous Diabetic Foot Ulcers (MiFoot)

National Institute for Health Research

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History

Author affiliation

College of Life Sciences/Population Health Sciences

Version

  • VoR (Version of Record)

Published in

Diabetes research and clinical practice

Volume

209

Pagination

111590

Publisher

Elsevier BV

issn

0168-8227

eissn

1872-8227

Copyright date

2024

Available date

2024-03-14

Spatial coverage

Ireland

Language

eng

Deposited by

Professor David Webb

Deposit date

2024-03-07

Rights Retention Statement

  • No

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