Dear Editor,

Worldwide, diabetes-related complications result in the amputation of a lower limb every 30 seconds.1 I commend Takehara, Oe, Ohashi, Tsumemi, Kadowaki, and Sanada for their contribution, "Differences Between Patient-Reported Versus Clinician-Observed Nonulcerative Signs and Symptoms of the Foot in Patients With Diabetes Mellitus (J Wound Ostomy Continence Nurs. 2019;46(2):113-116), for bringing additional attention to the need for continuing focus on the feet of diabetic patients. The strength of their research is their advocation for increasing patient education, including how often patients should observe their feet, and how to recognize symptoms that may elevate their risk for a diabetic foot ulcer.

Patient education and early diagnosis treatment can help prevent serious complications of diabetes because the diabetic foot is a serious complication of diabetes with high mortality, morbidity, and cost of treatment.2 Their findings support that of other researchers who have also concluded that foot self-care educational interventions were effective in improving foot self-care knowledge, self-efficacy, and behaviors in adult patients with type 2 diabetes at low risk for foot ulceration.3 Johnston and colleagues4 surveyed 772 diabetic patients at risk for foot complications at Veterans Affairs Medical Centers in the United Stated and reported that only 32.2% of participants reported inspecting at the bottom of their feet daily. Amputation is one of the most feared complications of diabetes, but I assert that patients are not provided adequate education about preventive measures to prevent and/or reduce this tragic outcome. Nemcova and Hlinkova5 also advocate for educating patients with diabetes in order to create and enable behaviors that promote the prevention of diabetic foot ulcers and amputation.

Sincerely,

Jacqueline E. Sharpe, PhD, RN, CHES

Program Coordinator for the BSHS Degree

Hampton University School of Nursing

Hampton, Virginia

[email protected]

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