{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T18:49:25Z","timestamp":1791658165795,"version":"4.3.4"},"reference-count":57,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,11,5]],"date-time":"2023-11-05T00:00:00Z","timestamp":1699142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100016058","name":"Townsville Hospital and Health Service","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100016058","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002129","name":"Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003550","name":"Queensland Government","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003550","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    This systematic review and meta\u2010analysis pooled evidence from randomised controlled trials (RCTs) on the effectiveness of educational programs for people with or at risk of diabetes\u2010related foot disease (DFD). A systematic search identified RCTs evaluating the effectiveness of educational programs in preventing or managing DFD. The primary outcome was risk of developing a foot ulcer. Secondary outcomes included any amputation, mortality, changes in cardiovascular risk factors, foot\u2010care knowledge and self\u2010care behaviours. Meta\u2010analyses were performed using random effects models. Risk of bias was assessed using Cochrane's ROB\u20102 tool. Education programs were tested in 29 RCTs (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a03891) and reduced risk of a foot ulcer by approximately half although the upper 95% confidence interval (CI) reached 1.00 (odds ratio [OR], OR 0.54; 95% CI 0.29, 1.00,\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u00a0=\u00a065%). Education programs reduced risk of any amputation (OR 0.34; 95% CI 0.13, 0.88,\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u00a0=\u00a038%) and HbA1c levels (standardized mean difference \u22120.73; 95% CI \u22121.26, \u22120.20,\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u00a0=\u00a093%) without affecting all\u2010cause mortality (OR 1.09; 95% CI 0.57, 2.07,\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u00a0=\u00a00%). Education programs mostly significantly improved DFD knowledge (13 of 16 trials) and self\u2010care behaviour scores (19 of 20 trials). Only one trial was deemed at low risk of bias. Previously tested education programs have mostly effectively improved participants' knowledge and self\u2010care behaviours and reduced risk of foot ulceration and amputation. Larger high quality trials with longer follow\u2010up are needed.\n                  <\/jats:p>","DOI":"10.1002\/dmrr.3746","type":"journal-article","created":{"date-parts":[[2023,11,5]],"date-time":"2023-11-05T20:14:10Z","timestamp":1699215250000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Effectiveness of educational interventions for diabetes\u2010related foot disease: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"40","author":[{"given":"Aaron","family":"Drovandi","sequence":"first","affiliation":[{"name":"Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry James Cook University  Townsville Queensland Australia"},{"name":"School of Biomedical Sciences Faculty of Biological Sciences University of Leeds  Leeds West Yorkshire 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