Health-related quality of life in diabetic patients with foot ulcers: literature review.

Foot ulcers are a common, serious, and costly complication of diabetes, preceding 84% of lower extremity amputations in diabetic patients and increasing the risk of death by 2.4-fold over diabetic patients without ulcers. Health-related quality of life (HRQOL) is worse among individuals with diabetes than individuals without diabetes, and complications of diabetes, including foot ulcers, have a major negative effect on HRQOL. Diabetic foot ulcers are associated with reduced mobility and deficits related to activities of daily living that adversely affect HRQOL. Qualitative studies have confirmed clinical observations that diabetic foot ulcers have a huge negative psychological and social effect, including reduction in social activities, increased family tensions for patients and their caregivers (spouses or partners), limited employment, and financial hardship. Quantitative studies confirm the findings of qualitative studies that diabetic foot ulcers exert a negative effect on physical functioning, psychological status, and social situation. Recent advances include the development and validation of disease-specific HRQOL surveys for diabetic patients with foot ulcers. Disease-specific surveys may improve the evaluation of HRQOL as a function of ulcer healing, the effect of different treatment methods on HRQOL, and the relationship between treatment-specific HRQOL, patient compliance, and treatment efficacy.