Future Directions for Diabetic Foot Ulcer Interventions: A Scoping Review of Continuous Glucose Monitoring-based Telemedicine.

OBJECTIVES

Nonadherence to diabetes treatment leads to persistent hyperglycemia, a key driver of nonhealing diabetic foot ulcers (DFUs). Continuous glucose monitoring (CGM) and telemedicine have independently improved glycemic management, glycated hemoglobin levels, and time in range. In this study we review the various components of telemedicine and CGM to gain insight that could contribute to future directions for enhancing DFU interventions.

METHODS

A scoping review was conducted through searches involving PubMed, Embase, CINAHL, and Scopus.

RESULTS

Sixteen studies were included in this review. Overall, 3 main implication areas, the first one with subdivisions, were identified: 1) Components in a remote treatment package, subdivided by a) The telemedicine term, b) The specialized health-care professional, c) Monitoring health data, and d) Supervision and feedback on monitored data; 2) Improved glycemic management with remote treatment; and 3) Future directions for DFU interventions.

CONCLUSIONS

Selected components of telemedicine and CGM may be used in future DFU interventions, but they need to be tested in a future feasibility study.