Evaluating a Lifestyle Intervention to Prevent Recurrence of Diabetic Foot Ulcers

Diabetic foot ulcers (DFUs) are a significant complication of diabetes, responsible for 80% of lower extremity amputations in the United States and posing a substantial burden on patients and society. Despite treatment, up to 23% of DFUs remain unhealed at 12 months, with recurrence rates of 40% within a year and 65% within three years. Proper offloading of foot pressure and glucose control is crucial for preventing recurrent DFUs, especially in cases of neuropathy. While standard clinical practice includes patient education and therapeutic footwear prescription, adherence to offloading treatment often falls short due to non-medical factors such as insufficient understanding and difficulties integrating offloading into daily routines. To tackle these challenges, we propose a lifestyle-focused intervention, conducted by trained occupational therapist (OT), aiming at fostering consistent self-care habits and routines.The objective of this pilot trial is to evaluate the feasibility acceptability of a lifestyle-focused OT intervention for enhancing offloading treatment in high-risk individuals with a history of healed DFUs.

Inclusion criteria

• Age >= 21 years
• Healed diabetic foot ulcer within the past twelve months
• Able to walk independently (use of a cane is acceptable)

Exclusion criteria

• Current active diabetic foot ulcer
• History of amputation beside toe or part of the foot
• Non-ambulatory at baseline
• Self-reported deafness/blindness.