PURPOSE: Diabetic patients with severe diabetic neuropathy often have hypoesthesia\nand numbness. This study evaluated foot self-care behavior according\nto severity of diabetic neuropathy. METHODS: We used a hand-held nerve\nconduction test device DPN check (HDN-1000, Omron) to evaluate severity of\ndiabetic neuropathy. Foot self-care was evaluated using the Japanese SDSCA\n(the Summary of Diabetes Self-Care Activities measure). Foot self-care comprised\nvisual inspection, washing, wiping interdigital areas, and checking shoes,\nand was scored according to the number of days self-care which was performed\nin the previous week. RESULTS: The study evaluated 103 diabetic patients (age:\n65.7 years, diabetes duration: 13.9 years, HbA1c: 7.3%). Total scores (out of 28\npoints) for self-care behavior according to neuropathy severity were 11.8 (Normal:\nn = 54), 10.6 (Mild: n = 27), 13.3 (Moderate: n = 17), and 10.8 (Severe: n =\n5). Foot self-care scores were low in all groups, with particularly low scores in\nthose with severe neuropathy. However, no statistically significant differences\nwere observed. CONCLUSIONS: Foot self-care is essential in diabetes because\nlesions are more likely to occur in severe neuropathy. Living alone and the\npresence of recurrent foot lesions are associated with poor survival prognosis.\nAccordingly, foot-care intervention must take neuropathy severity and lifestyle\nfactors into account. The severity of diabetic neuropathy must be determined\nand foot-care intervention should take lifestyle factors into account.
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