Holistic Management of Diabetic Ulcer in Construction Worker with Low-Risk Neuropathy Symptoms Score and Proximal Phalanx Diggiti III-IV Pedis Dextra Amputation History

Abstract : Diabetic ulcers are the most common complication of uncontrolled Diabetes Mellitus (DM), characterized by high blood glucose levels that lead to complications such as neuropathy (motor, sensory, autonomic) and vascular abnormalities, making infections more likely. According to research in Indonesia, the incidence of diabetic ulcers ranges from 15-25% of the total number of diabetes mellitus patients, with an annual prevalence of 2% to 5-7.5% in patients with neuropathy. Application of evidence-based medicine-based family doctor services to patients by identifying risk factors, clinical problems, and patient management based on a patient-centered and family problem-solving framework. This case report taken by primary data through auto-anamnesis, physical examination and home visits. Secondary data was obtained from the patient’s medical record. The assessment is based on a holistic diagnosis from entire of the study qualitatively and quantitatively. Patient Mr. E, 61 years old has internal factor risks such as elderly age, curative treatment patterns, inappropriate eating habits, lack of knowledge about the disease which, and external risk factors in the form of curative family treatment patterns and lack of family support related to patient’s disease. Patient’s management is holistic and comprehensive, patient-centered, family approach, and community-based in the literature based on EBM. Patient was intervened with media posters about DM, diet, proper diabetic ulcer care and educating families to support patients. Results of the intervention evaluation are increase in patient and family’s knowledge, controlled blood sugar, and eating behavior according to Adequacy of Nutrition Level.