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Letter to Editor Volume 5 Issue 4
A dress does not fit everyone
Alessandro Mantovani,
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Ilaria Teobaldi
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Section of Endocrinology, Diabetes and Metabolism, Azienda Ospedaliera Universitaria Integrata of Verona, Italy
Correspondence: Alessandro Mantovani, Section of Endocrinology, Diabetes and Metabolism Azienda Ospedaliera Universitaria Integrata of Verona, Italy
Received: August 15, 2018 | Published: August 20, 2018
Citation: Mantovani A, Teobaldi I. A dress does not fit everyone. J Diabetes Metab Disord Control. 2018;5(4):145. DOI: 10.15406/jdmdc.2018.05.00154
Summary
Based on the recent opinion of Miranda and Da Ros about the patient education on foot care in order to prevent diabetic foot ulceration, in this “Letter to the Editor” we suggest that healthcare professionals, who handle the diabetic foot problems, should also take into account that, when compared to the white majority, some racial and ethnic minorities (that are increasing in Europe) have specific cultures, histories, languages, and characteristics that might have a different effect on their risk of diabetes mellitus, sensitivity to screening, response to treatment, and access to care. Therefore, initiatives and interventions that specifically target racial and ethnic minorities, as well as their peculiar characteristics, should be timely implemented into any therapeutic patient education for the prevention of diabetic foot. In a coming age of precision medicine, we have to acknowledge that a dress does not fit everyone and organize the patient education programs on foot care accordingly.
Keywords: diabetic foot, diabetic foot ulceration, therapeutic prevention program
Introduction
We have read with interest the manuscript of Miranda and Da Ros, which was recently published in this Journal.1 We completely agree with the Authors that education of the patient with diabetes mellitus regarding foot care is effective for the prevention of diabetic foot ulceration.1‒3 Importantly, this is even more evident when such education is structured, organized, repetitive, and combined with multiple preventive interventions.1‒3 However, we believe that another relevant (albeit not much acknowledged) aspect should be considered regarding this issue.
In Europe (and also in Italy), some racial and ethnic minorities (e.g., black or Africans, Asian, Indians and Latinos) have a relatively larger burden of diabetes mellitus when compared to the white majority.4 These include a higher prevalence of type 2 diabetes mellitus, lower rates of diagnosis, but also a higher rate of diabetic complications, including diabetic foot.4 Importantly, the aforementioned racial and ethnic minorities have different cultures, histories, languages, and characteristics (e.g, biological, genetic and environmental) that might have an (adverse) effect on their risk of diabetes mellitus, sensitivity to screening, response to treatment, and access to care.4
We believe that, to date, all these relevant aspects should be always taken into consideration by the (multidisciplinary) foot care services when they handle the complex foot problems, in order to offer to everyone a fair and adequate medical service. Hence, initiatives and interventions (e.g., cultural mediators, appropriate tools translated into different languages) that specifically target such racial and ethnic minorities, as well as their specific characteristics, should be timely implemented into any therapeutic education program for the prevention of diabetic foot. Importantly, the possibility to overwhelm any barrier, in order to obtain health equity for all individuals, will only be possible when we (as healthcare professionals) will acknowledge that racial and ethnic minorities are peculiar and, consequently, we will incorporate their differences in our everyday activities. In a coming age of precision medicine, we should recognize that a dress does not fit everyone, also when we organize the therapeutic patient education in the prevention of diabetic foot.
Acknowledgements
None.
Conflict of interest
The author declares that there is no conflict interest.
References
- Miranda C, Da Ros R. Therapeutic education patient in prevention of diabetic foot: a neglected opportunity. J Diabetes Metab Disord Control. 2018;5(4):127‒130.
- Schaper NC, Van Netten JJ, Apelqvist J, et al. International Working Group on the Diabetic Foot. Prevention and management of foot problems in diabetes: A Summary Guidance for Daily Practice 2015, based on the IWGDF Guidance. Diabetes Metab Res Rev. 2016;32(1):7‒15.
- Mishra SC, Chhatbar KC, Kashikar A, et al. Diabetic foot. BMJ. 2017;359.
- The Lancet Diabetes Endocrinology. Screening thresholds: one size does not fit all. Lancet Diabetes Endocrinol. 2018;6(4):259.
©2018 Mantovani, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.