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Lebensqualität von Patienten mit diabetischem Fußulkus

Quality of life of patients with diabetic foot ulcers

  • Leitthema
  • Published:
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Zusammenfassung

Hintergrund

Diabetesassoziierte Komplikationen wie das diabetische Fußulkus (DFU) verschlechtern die ohnehin eingeschränkte gesundheitsbezogene Lebensqualität von Diabetikern erheblich.

Ziel der Arbeit

Die Arbeit gibt eine Zusammenfassung über die Lebensqualität von Patienten mit DFU und stellt Instrumente zur Erfassung der krankheitsspezifischen Lebensqualität dieser Patienten vor.

Material und Methoden

Zusammenfassung der aktuellen Literatur.

Ergebnisse

Das DFU geht mit deutlichen Einschränkungen der physischen, mentalen und sozialen Aspekte der Lebensqualität einher. Als besonders belastend werden die Limitierung der Mobilität und damit verbunden der Verlust der Eigenständigkeit empfunden. Nach Abheilung des Ulkus bessert sich die Lebensqualität zumeist wieder. Erfolgreiche Minoramputationen werden ebenso positiv wie konservativ abgeheilte Ulzera erlebt. Mit der Diabetic Foot Ulcer Scale (DFS) und dem NeuroQoL stehen krankheitsspezifische Fragebögen für Studien und Verlaufskontrollen zur Verfügung.

Schlussfolgerungen

Das DFU hat einen starken negativen Effekt auf die Lebensqualität. Eine erfolgreiche Therapie geht mit einer messbaren Besserung der selbst empfundenen Lebensqualität einher. Die zur Verfügung stehenden krankheitsspezifischen Tests können helfen, therapeutische Verfahren besser zu beurteilen.

Abstract

Background

Diabetes-associated complications, such as diabetic foot ulcers (DFU) have a huge negative impact on the health-related quality of life of diabetic patients.

Objective

This article gives a brief summery of the quality of life of patients with DFU and presents instruments to assess the disease-specific quality of life in these patients.

Material and methods

A review of the literature was carried out.

Results

The presence of DFU is associated with a poor quality of life in all aspects of physical, mental and social well-being. Reduced mobility has been noted as the major burden. Healing of DFUs is associated with improvement in the quality of life. Successful minor amputations do not have a negative impact on the quality of life. The DFU scale (DFS) and the NeuroQoL are valuable instruments for assessing the disease-specific quality of life in patients with DFU in studies and clinical practice.

Conclusion

The DFU has a strong negative impact on the quality of life. Successful therapy is associated with a marked improvement in the self-assessed quality of life. The available disease-specific questionnaires are helpful to assess the value of new therapies.

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Literatur

  1. Abetz L, Sutton M, Brady L, McNulty P, Gagnon DD (2002) The Diabetik Foot Ulcer Scale (DFS): a quality of life instrument for use in clinical trials. Pract Diabetes Int 19:167–175

    Article  Google Scholar 

  2. Ashford RL, McGee P, Kinmond K (2000) Perception of quality of life by patients with diabetic foot ulcers. Diab Foot 3:150–155

    Google Scholar 

  3. Bann CM, Fehnel SE, Gagnon DD (2003) Development and validation of the Diabetic Foot Ulcer Scale-short form (DFS-SF). Pharmacoeconomics 21:1277–1290

    Article  PubMed  Google Scholar 

  4. Boutoille D, Fraille A, Maulaz D, Krempf M (2008) Quality of life with diabetes-associated foot complications: Comparison between lower-limb amputation and chronic foot ulceration. Foot Ankle Int 29:1074–1078

    Article  PubMed  Google Scholar 

  5. Brod M (1998) Quality of life issues in patients with diabetes and lower extremity ulcers: patients and care givers. Qual Life Res 7:365–372

    Article  CAS  PubMed  Google Scholar 

  6. Davies M, Brophy S, Williams R, Taylor A (2006) The prevalence, severity, and impact of painful diabetic peripheral neuropathy in type 2 diabetes. Diabetes Care 29:1518–1522

    Article  PubMed  Google Scholar 

  7. Engelhardt M, Bruijnen H, Scharmer C, Jezdinsky N, Wölfle K (2006) Improvement of quality of life six months after infrageniculate bypass surgery: Diabetic patients benefit less than non-diabetic patients. Eur J Vasc Endovasc Surg 32:182–187

    Article  CAS  PubMed  Google Scholar 

  8. Engelhardt M, Bruijnen H, Scharmer C, Wohlgemuth WA, Willy C, Wölfle KD (2008) Prospective 2‑years follow-up quality of life study after infrageniculate bypass surgery for limb salvage: Lasting improvements only in non-diabetic patients. Eur J Vasc Endovasc Surg 36:63–70

    Article  CAS  PubMed  Google Scholar 

  9. Engelhardt M, Elias K, Augustin M, Debus ES (2015) Erfassung der Lebensqualität bei chronischen Wunden und Gefäßerkrankungen. Gefasschirurgie 20:10–17

    Article  Google Scholar 

  10. Fejfarová V, Jirkovská A, Dragomirecká E, Game F, Bém R, Dubský M, Wosková V, Křížová M, Skibová J, Wu S (2014) Does the diabetic foot have a significant impact on selected psychological or social characteristics of patients with diabetes mellitus? J Diabetes Res 2014:1–7

    Google Scholar 

  11. García-Morales E, Lázaro-Martínez JL, Martínez-Hernández D, Aragón-Sánchez J, Beneit-Montesinos JV, González-Jurado MA (2011) Impact of diabetic foot related complications on the health related quality of life (HRQoL) of patients – a regional study in Spain. Int J Low Extrem Wounds 10:6–11

    Article  PubMed  Google Scholar 

  12. Gilpin H, Lagan K (2008) Quality of life aspects associated with diabetic foot ulcers: a review. Diabet Foot J 11:56–62

    Google Scholar 

  13. Goodridge D, Trepman E, Sloan J, Guse L, Strain LA, McIntyre J, Embil JM (2006) Quality of life of adults with unhealed and healed diabetic ulcers. Foot Ankle Int 27:274–280

    Article  PubMed  Google Scholar 

  14. Gore M, Brandenburg NA, Dukes E, Hoffman DL, Tai KS, Stacey B (2005) Pain severity in diabetic peripheral neuropathy is associated with patient functioning, symptom levels of anxiety and depression, and sleep. J Pain Symptom Manage 30:374–385

    Article  PubMed  Google Scholar 

  15. Hogg FRA, Peach G, Price P, Thompson MM, Hinchliffe RJ (2012) Measures of health-related quality of life in diabetes-related foot disease: a systematic review. Diabetologia 55:552–565

    Article  CAS  PubMed  Google Scholar 

  16. Jaksa PJ, Mahoney JL (2010) Quality of life in patients with diabetic foot ulcers: validation of the cardiff Woiund impact schedule in a Canadian population. Int Wound J 7:502–507

    Article  PubMed  Google Scholar 

  17. Jensen MP, Chodroff MJ, Dworkin RH (2007) The impact of neuropathic pain on health-related quality of life: review and implications. Neurology 68:1178–1182

    Article  PubMed  Google Scholar 

  18. Keinanen-Kiukaanniemi S, Ohinmaa A, Pajunpaa H, Koivukangs P (1996) Health related quality of life in diabetic patients by the Nottingham Health Profile. Diabet Med 13:382–388

    Article  CAS  PubMed  Google Scholar 

  19. Kinmond K, McGee P, Gough S, Ashford R (2002) Loss of self: a psychosocial study of the quality of life of adults with diabetic ulceration. http://www.worldwidewounds.com/2003/may/Kinmond/Loss-Of-Self.html

    Google Scholar 

  20. Lepäntalo M, Apelqvist J, Setacci C, Ricco JB, de Donato G, Becker F et al (2011) Chapter V: diabetic foot. Eur J Vasc Endovasc Surg 42:S60–S74

    Article  PubMed  Google Scholar 

  21. Nabuurs-Franssen MH, Huijberts MS, Nieuwenhuijzen Kruseman AC, Willems J, Schaper NC (2005) Health-related quality of life of diabetic foot ulcer patients and their caregivers. Diabetologia 48:1906–1910

    Article  CAS  PubMed  Google Scholar 

  22. Pickwell K, Siersma V, Kars M, Apelqvist J, Bakker K, Edmonds M et al (2016) Minor amputation does not negatively affect health-related quality of life as compared to conservative treatment in patients with a diabetic foot ulcer: an observational study. Diabetes Metab Res Rev. doi:10.1002/dmrr.2867

    PubMed  Google Scholar 

  23. Price P, Harding K (2004) Cardiff Wound Impact Schedule: the development of a condition-specific questionnaire to assess health-related quality of life in patients with chronic wounds of the lower limb. Int Wound J 1:10–17

    Article  PubMed  Google Scholar 

  24. Ribu L, Hanestad BR, Moum T, Birkeland K, Rustoen T (2007) Health-related quality of life among patients with diabetes and foot ulcers: association with demographic and clinical characteristics. J Diabetes Complicat 21:227–236

    Article  PubMed  Google Scholar 

  25. Ribu L, Hanestad BR, Moum T, Birkeland K, Rustoen T (2007) A comparison of the health-related quality of life in patients with diabetic foot ulcers, with a diabetes group and a nondiabetes group from the general population. Qual Life Res 16:179–189

    Article  PubMed  Google Scholar 

  26. Ribu L, Birkeland K, Hanestad BR, Moum T, Rustoen T (2008) Longitudinal study of patients with diabetes and foot ulcers and their health-related quality of life: wound healing and quality-of-life changes. J Diabetes Complicat 22:400–407

    Article  PubMed  Google Scholar 

  27. Sekhar MS, Thomas RR, Unnikrishnan MK, Vijayanarayana K, Rodrigues GS (2015) Impact of diabetic foot ulcer on health-related quality of life: a cross-sectional study. Semin Vasc Surg 28:165–171

    Article  PubMed  Google Scholar 

  28. Tamayo T, Rathmann W (2016) Epidemiologie des Diabetes in Deutschland. In: Danne T, Gallwitz B, Deutsche Diabetes-Hilfe, Deutsche Diabetes Gesellschaft (DDG) (Hrsg) Deutscher Gesundheitsbericht Diabetes 2016 – Die Bestandaufnahme. Kirchheim, Mainz, S 9–17

    Google Scholar 

  29. Valensi P, Girod I, Baron F, Moreau-Defarges T, Guillon P (2005) Quality of life and clinical correlates in patients with diabetic foot ulcers. Diabetes Metab 31:263–271

    Article  CAS  PubMed  Google Scholar 

  30. Vileikyte L, Rubin RP, Leventhal H (2004) Psychological aspects of diabetic neuropathic foot complications: an overview. Diabetes Metab Res Rev 20:13–18

    Article  Google Scholar 

  31. Vileikyte L, Peyrot M, Bundy C et al (2003) The development and validation of a neuropathy- and foot ulcer specific quality of life instrument. Diabetes Care 26:2549–2555

    Article  PubMed  Google Scholar 

  32. Vinik EJ, Hayes RP, Oglesby A et al (2005) The development and validation of the Norfolk QOL-DN, a new measure of patients‘ perception of the effects of diabetes and diabetic neuropathy. Diabetes Technol Ther 7:497–508

    Article  PubMed  Google Scholar 

  33. Wandell PE, Brorsson B, Aberg H (1998) Quality of life among diabetic patients in Swedish primary health care and in the general population: comparison between 1992 and 1995. Qual Life Res 7:751–759

    Article  CAS  PubMed  Google Scholar 

  34. Wohlgemuth WA, Safonova O, Engelhardt M, Freitag M, Wölfle K, Kirchhof K (2008) Improvement of the quality of life concerning the health of patients with peripheral arterial disease (PAD) after successful bypass surgery. Vasa 37:338–344

    Article  CAS  PubMed  Google Scholar 

  35. Yekta Z, Pourali R, Ghasemi-rad M (2011) Comparison of demographic and clinical characteristics influencing health-related quality of life in patients with diabetic foot ulcers and those without foot ulcers. Diabetes Metab Syndr Obes 4:393–399

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Klinik für Gefäßchirurgie und Endovaskuläre Chirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland

    M. Engelhardt, N. Rashad & T. Beck

  2. Klinik und Poliklinik für Gefäßmedizin, Universitäres Herzzentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    E. S. Debus

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  1. M. Engelhardt
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  2. N. Rashad
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  3. E. S. Debus
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  4. T. Beck
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Correspondence to M. Engelhardt.

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Interessenkonflikt

M. Engelhardt, N. Rashad, E. S. Debus und T. Beck geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Engelhardt, M., Rashad, N., Debus, E.S. et al. Lebensqualität von Patienten mit diabetischem Fußulkus. Gefässchirurgie 22, 174–179 (2017). https://doi.org/10.1007/s00772-017-0266-7

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