An estimation of diabetes foot self-care based on validated scores: A systematic review and meta-analysis

A diabetic foot ulcer is a preventable complication of diabetes, which could lead to lower extremity amputation and increased mortality and morbidity. Self-care behaviors play a key role in the prevention of diabetic foot ulcers. This study aimed to estimate the total score of diabetic foot self-care behaviors. We searched databases such as Web of Science, Medline (PubMed), and Scopus using various keywords, including diabetic foot, diabetic feet, diabetic problem, diabetic foot ulcer, and self-care, for relevant articles with no time limit. The heterogeneity of the studies was assessed using Cochran's Q test and I² statistic. Data were analyzed using STATA software version 12 using the meta-analysis method and a random effects model. In total, eight studies were analyzed with a sample size of 2,493. The pooled score of diabetes foot self-care was 62.84% and this score was higher in the studies conducted on two groups of patients with type I and type II diabetes compared to those performed only on patients with type II diabetes. The results also indicated correlation between the self-care score and year of publication (P < 0.001), and the self-care scores significantly declined during 2015-2021 (P < 0.001). Overall, the diabetic foot self-care score was moderate, which highlights the need to provide self-care education to diabetic patients.