title: Evaluation of the impact of podiatrist care in the primary prevention of foot problems in diabetic subjects.
abstract: OBJECTIVE
  To evaluate the influence of podiatrist activities on the outpatient care of diabetic patients in terms of knowledge of diabetic foot care, self-care, and minor foot problems.
  
  
  METHODS
  There were 733 patients, aged 10-79 years, identified from the national diabetes register. Patients without recent visits to a podiatrist and without an obvious need for foot care were randomized into a podiatric care group (education and primary prevention measures, n = 267) and a control group (written instructions only, n = 263). The patients were examined by an independent study podiatrist at baseline and after 1 year.
  
  
  RESULTS
  Patients in the podiatrist group had greater improvement in knowledge of diabetic foot care (P = 0.004) and self-care (P < 0.001) scores compared with control subjects. The prevalence of callosities in regions other than the calcaneal region decreased more (P = 0.009) in the podiatrist group (from 54.5 to 39.5%) than in the control group (from 51.3 to 48.2%), and the size of the callosities decreased more (P < 0.001) in the podiatrist group than in the control group. Reduction in the prevalence of callosities was associated with younger age (< 50 years).
  
  
  CONCLUSIONS
  Education and primary preventive measures provided individually by a podiatrist result in significant improvements in knowledge and foot self-care scores and in improvements in the prevalence of some minor foot problems. Long-term studies are needed to evaluate whether the intervention of podiatrists starting at an early phase would lead to a reduction in major foot problems.
authors.affiliation: Department of Medicine, University of Turku, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Rönnemaa
authors.forename: H
authors.initials: H
authors.lastname: Hämäläinen
authors.forename: T
authors.initials: T
authors.lastname: Toikka
authors.forename: I
authors.initials: I
authors.lastname: Liukkonen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015331:Cohort Studies; D017719:Diabetic Foot / Q000517:prevention & control*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D005534:Foot Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010819:Physician's Role; D011032:Podiatry; D015995:Prevalence; D011322:Primary Prevention; D012648:Self Care