Non-pharmacological Interventions for the Prevention and Progression of Diabetic Foot Ulcers in Individuals With Type 2 Diabetes Mellitus: A Scoping Review

Diabetic foot ulcers (DFUs) are a common complication of diabetes, significantly impairing patients' quality of life (QoL) and imposing a heavy economic burden. Previous reviews on the prevention of DFUs and their recurrence have indicated that educational interventions alone cannot definitively reduce the incidence of new DFUs or lower limb amputation rates and that non-pharmacological therapies using medical devices face challenges such as cost, the need for technical training, and infrastructure development. This study systematically mapped the existing literature on non-pharmacological therapies, excluding medical devices and medications. Specifically, interventions involving machinery were excluded. The aim was to identify strategies that prevent delayed progression and recurrence of diabetic foot ulcers (DFU) in patients with type 2 diabetes. The review focused on interventions with high feasibility, cost-effectiveness, and sustainability, such as patient education, behavior modification, monitoring, and multidisciplinary collaboration. These approaches are expected to contribute to the development of comprehensive and practical strategies that address current knowledge gaps, improve patient outcomes, reduce healthcare costs, and enhance the quality of life for individuals with diabetes. An exploratory review was conducted using a combination of controlled vocabulary and free text terms related to "type 2 diabetes," "ulcer," "intervention," and "prevention." Data were collected from PubMed, the Cochrane Central Register of Controlled Trials, and Ichushi-Web. Eleven studies were evaluated. The intervention methods used were face-to-face methods by healthcare professionals and methods utilizing information and communication technology (ICT). The outcome measures of the interventions varied, including changes in patients' cognitive behavior, assessment of quality of life, examination of the condition of the lower limbs, such as ulcer healing and skin condition of the feet, and evaluation of diabetes management. This review emphasizes that non-pharmacological therapies, particularly those incorporating multidisciplinary educational interventions involving nurses, may be effective in preventing diabetic foot ulcers (DFUs) and preventing their recurrence. Future research should aim to establish standardized outcome measures and evidence-based guidelines for integrating face-to-face and ICT-based multidisciplinary educational interventions.