Provision of assistive devices for people with diabetes at risk of mobility impairment

Abstract

Whilst diabetes is a growing global health problem, diabetic foot disease is one of the most expensive complications of diabetes leading to significant morbidity and mortality in the adult population. Previous research has clearly highlighted the limitations of currently available diabetic foot screening guidelines; which aim to identify patients at risk of foot complications, such as ulcerations and amputations, and who therefore may require mobility assistive devices. Also, there are differences between screening guideline recommendations at the national level and this contributes to the differences in national diabetic foot disease outcomes and associated burden. There is also a lack of high quality evidence on which these guidelines are based which is responsible for the current gaps between guidelines, standard clinical practice, and development of complications. Whilst indicating that diabetes is associated with a clear increase in the risk of physical disability, studies have called for efforts to promote healthy ageing and strategies for mitigating this risk through prevention and management. In addition, reports showcase that diabetes related lower extremity complications are one of the leading causative factors in the global burden of disability. This study focussed on publicly available datasets to retrieve relevant information relating to physical disability as a result of diabetes. It also examined the national guidelines for screening and their relationship to global guidelines. Whilst publicly available datasets highlight and host up to date information on the global burden of the diabetes, it has little or no information relating to the complications resulting from diabetes and in particular no data on amputations or mobility related assistive devices. There is a clear need for collecting structured data during screening at a primary care level. This, in addition to helping to reduce the complications of the disease will help to understand the assistive technology needs of these patients.