A group of academics from Glasgow Caledonian University have received nearly £300,000 to test a new interviewing theory that aims to prevent diabetes-related foot ulcers.

The Scottish Government’s Chief Scientist Office has given Dr Jodi Binning, Dr Gordon Hendry and Dr Ruth Barn £299,751 to conduct a study that analyses diabetes-related foot ulcers, especially in deprived neighbourhoods.

As part of the trial, the team are hoping to find that interviewing people with diabetes will motivate them to change their lifestyles and in turn reduce their risk of developing foot ulcers.

Foot ulcers are also associated with other severe health complications, such as amputation, and in some cases even death.

Appearing below the ankle, foot ulcers impact 19% to 34% of individuals living with diabetes, particularly those from a deprived area.

Typically, deprived areas suffer from poor education, high crime rates, high unemployment and poor health among the population.

Prior research conducted by Glasgow Caledonian University has revealed the individuals with diabetes living in deprived neighbourhoods are up to five times more at risk of developing a foot ulcer or having an amputation compared to those from more affluent areas.

Dr Barn stated: “Current treatment approaches are not effective. People with diabetes are well informed about their condition but this does not necessarily lead to a behaviour change.

“We have developed a new treatment based on motivational interviewing – a way of having a conversation with a person that helps them understand their reasons and barriers to positive lifestyle change, and supports adoption of new behaviours, or stopping unhelpful behaviours, to prevent foot ulcers.”

She added: “This approach has previously been successful for people attending services in other areas such as addictions, long-term condition management and weight loss.

“Our aim is to undertake a small trial, comparing motivational interviewing to current care, to find out if a larger trial is possible and worth doing.

“We hope that this intervention could empower people with diabetes and foot ulceration, leading to improved self-care, and reduced ulceration and amputation rates, in the long run.”

As part of the three-year pilot, podiatrists will be trained on how to deliver motivational interviews to people at risk of developing foot ulcers.

In a previous research study, Dr Binning found that motivational interviewing helped combat the development of foot ulcers in people who live in deprived areas of Glasgow.

She said: “People involved in the study said that the approach is more individualised and feels different. Of the 17 people who took part, 15 reported positive behaviour changes.”

Dr Hendry noted: “While motivational interviewing intervention is focused on behaviour change, the actual outcome we are interested in reducing is the number of ulcers that people develop during that follow up period.

“As little as a 10% reduction in ulceration rate could bring significant cost benefits to the NHS and would be enough to justify a much larger future trial.”

He added: “It’s possible that a little bit of behaviour change chosen and driven by patients themselves, with the support of highly trained podiatrists, will have a tangible effect on reducing ulceration and amputation rates in a group that has greater need.”

A spokesperson from the Scottish Government said: “Diabetes is a clinical priority for the Scottish Government and by funding this innovative pilot we hope that progress can be made in tackling diabetes-related foot ulceration in some of the country’s most deprived areas.

“We know that diabetes remains a significant health challenge and a leading cause of ill health in Scotland.”

They added: “In February 2021, we updated our Diabetes Improvement Plan which sets out our priorities and commitments to improve the prevention, treatment and care for everyone living with diabetes in Scotland.

“The plan contains a specific commitment to support ongoing work to improve outcomes for people with foot disease and we look forward to the outcomes of this important project.”

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