Background:
The rising prevalence of Diabetes Mellitus (DM) and Chronic Kidney Disease (CKD) has led to increased secondary concerns due to their independent and unanimous contributions to elevated morbidity and mortality rates in people with diabetes, placing greater demands on healthcare systems. Concurrently, patients with CKD exhibit heightened foot disease outcomes (ulceration, amputation, and subsequent mortality), presenting complex clinical challenges. However, the intricate interplay between CKD, diabetes-related foot disease outcomes, and social deprivation remains unexplored. This study focuses on individuals with both DM and CKD, examining foot disease outcomes (DFU, amputations, mortality), with an exposure of interest in social deprivation, specifically socioeconomic status (SES) in this vulnerable population.
Aims:
This study will undertake a Systematic Review and Meta-Analysis to investigate the existing published literature on foot disease outcomes in people with diabetes and CKD, focusing on the role of social deprivation.
Hypotheses:
H0: No significant association between higher levels of social deprivation, CKD and foot disease outcomes in people with diabetes.
H1: Significant association between higher levels of social deprivation, CKD and foot disease outcomes in people with diabetes.
Objectives:
Diabetes, CKD, and socioeconomic disparities contribute synergistically to compromised foot health. The study objectives are to understand the complex relationship between CKD and foot health outcomes in people with diabetes, and socioeconomic factors in predicting clinically significant foot disease outcomes.
Research Impact:
This research may raise awareness of health disparities, aligning with the United Nations Sustainable Development Goals; Good Health and Wellbeing, and Reducing Inequalities. It will guide policies targeting people with diabetes, informing both social and healthcare interventions. The study emphasizes patient-level care, understanding individual exposure to deprivation and its impact on diabetes-related foot outcomes. It fosters a multidisciplinary approach in addressing the complex intersection of medical conditions and social determinants for improved patient outcomes and health equity.