Social isolation linked to ulcer severity in those with diabetic foot, study highlights

Shining the spotlight on social isolation could help improve outcomes for people with diabetes with foot ulcer, new research has recommended.

A study of 160 people found that people with less social interaction had a higher rate of more severe foot ulcer and were more likely to have never undergone a foot examination. They were also more likely to have delayed seeking help for their condition.

The research, conducted by a team from Southern Medical University in China, set out to explore the correlation between social isolation and health behaviours and ulcer severity.

The participants, who all have type 2 diabetes, were treated at Nanfang Hospital at the university between September 2020 and December 2021.

Participants’ data was collated, including their scores for Lubben Social Network Scale and the Wagner classification of foot ulcers. Their health behaviours were also examined, including whether they has received education on diabetes footcare, any delays in seeking treatment and how frequently they had received foot examinations.

The patients were divided into two groups, a social isolation group and a non-social-isolation group, and researchers compared the health behaviours and severity of foot ulcers of the two groups.

They reported: “The findings suggest that, compared with the non-social-isolation group, the social isolation group had a higher proportion of diabetes foot patients with Wagner grade 3-5 foot ulcers ( P<0.05).

“Analysis of the health behaviours showed that the social isolation group had a higher proportion of diabetes foot patients who had never undergone examination of their feet and those who had delayed attempts to access medical service for their condition ( P<0.05).”

The researchers said they did not find any significant differences between the two groups when it came to education around diabetes foot, but did find a link between greater social isolation and a longer delay in attempting to seek treatment.

They concluded: Social isolation is correlated to health behaviours and ulcer severity in patients with diabetes foot. Giving more attention to the problem of social isolation of diabetes foot patients and increasing their ties with the social environment and the members of their social network may have a positive effect on improving the delays in diabetes foot patients’ attempt to access medical service, which is particularly important for follow-up treatment.”

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