Video Review: Review of Preventing Diabetic Foot Ulcers: The 3-Step Program
Preventing Diabetic Foot Ulcers: The 3-Step Program is a professionally produced, non-commercial, 18-minute video designed to help people with diabetes and their family members understand three important steps they can take to help prevent a diabetic foot ulcer. The video recently won first place in the diabetes category of the 2005 International Health & Medical Media Awards (https://www.theFreddies.com). Catherine R. Ratliff, PhD, a member of the OWM Editorial Advisory Board, was a key consultant for this video project.
The video takes a friendly approach. A gentleman with diabetes and neuropathy demonstrates how to perform the daily foot check, a podiatrist presents examples of common foot problems of which patients should be aware, and Archie, a whimsical talking foot, explains why people with neuropathy must wear doctor-recommended shoes fit by a professional.
The three-part presentation begins with an explanation of neuropathy, addressing its etiology and the necessity for strict blood glucose control. Importantly, the video stresses the danger of neuropathy and its ultimate sequelae, which include callous, open cuts, ulcers, infection, and amputation. This is an extremely important — and often ignored — concept for patients to understand because people are programmed to believe that what doesn’t hurt can’t be harmful. Daily inspection of one’s feet for any abnormalities, checking socks for blood or pus, and looking and feeling for hot spots are important practices. Perhaps out of consideration for its “lay” audience, the video did not explain that neuropathy is a pan-systemic entity causing gastroparesis and decreased pain perception in the heart, lessening or eliminating the sensation of a heart attack. It also was not explained that peripheral neuropathy may affect the hands; thus, not allowing for proper sensory evaluation of warmth or heat. In those situations, it would behoove the clinician to suggest that another person should evaluate the feet with respect to feeling for hot spots.
Adequate graphics in step two depict the manifestation of certain pathologies and the necessity for adequate and proper footgear. Step three outlines what to do if one develops a problem and emphasizes the need for regular professional evaluation, as well as the importance of proper fitting foot gear.
Although certain portions of the video were repetitious and the overall length may need to be shortened to ensure viewer attention, the video provides patient/clinician talking points to maximize foot ulcer preventive measures in persons with diabetes.
