# Management of the Diabetic Foot in People with Diabetes Mellitus Older than 65 Years
## 3 Results  
The research question was constructed following the PICO format (population/patient, intervention, comparator and outcomes/outcomes). Detailed as P (population): people older than 65 years with diabetes mellitus; I (intervention): techniques to prevent diabetic foot; C (comparison): not applicable; O (results): achieve the greatest possible evidence available. (Scheme 1). Below is a table that shows the search strategy used to select the 22 articles selected from the 5 databases, following the criteria of identified studies, duplicate studies, title, abstract, full text and valid studies of a definitive nature (Table 1). The total number of valid articles is summarized in Table A3. \begin{table}
\begin{tabular}{c c c c c c c} \hline \hline
**Item Criteria** & **Medline/Pubmed** & **Google Scholar** & **WOS** & **Scielo** & **Scopus** & **Total** \\ \hline Identified & 232 & 88 & 287 & 11 & 200 & 818 \\ Duplicates & 3 & 3 & 2 & 4 & 1 & 150 \\ Title & 25 & 6 & 16 & 42 & 3 & 92 \\ \hline Abstract & 22 & 6 & 14 & 37 & 3 & 82 \\ Text complete & 13 & 6 & 9 & 16 & 3 & 47 \\ Valid & 5 & 4 & 7 & 11 & 3 & 22 \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Databases consulted. In the studies by [PERSON], [PERSON], [PERSON], [PERSON], [PERSON] and [PERSON], it is shown in reference to the educational level that 117 patients have not received education, 62 patients attended basic education and 813 had primary education [8; 9; 10; 11; 12; 13; 14]. In the study by [PERSON], [PERSON], [PERSON], [PERSON], [PERSON] and [PERSON], it was observed that 281 people had a good level of knowledge, 127 people had a moderate level, 258 people had a poor level and 77 people had a low level [9; 10; 11; 12; 13; 14]. In the study by [PERSON], [PERSON], [PERSON] and [PERSON], it was shown that 29 people have good foot care, 377 people had poor foot care and 4 people had inadequate foot care [9; 10; 11; 13]. In the study by [PERSON], [PERSON], [PERSON] and [PERSON], it was observed in relation to self-care practices that 154 of the participants performed a foot exam, 112 people applied cream, 147 people had dry feet and 119 users reported walking barefoot [9; 10; 11; 12]. To assess the magnitude of self-care practices, the criteria used were diet, physical exercise, adherence to medication, self-monitoring of blood glucose and foot care. In [PERSON]'s article, it was observed that 10.3% of users had blood insulin control, 59.5% had poor glycemic control and 15.1% had adequate glucose-control practices. In addition, 67.1% of the patients had little knowledge about diabetes. Regarding food, 69.4% had a dietary plan. In the exercise, 63.5% of the patients presented adequate management, and 82.9% of users complied with proper foot care. On the other hand, 60.7% of users showed good self-care. Regarding medication, 22.6% of users were taking metformin, 63.1% were using insulin, 4% were using insulin plus metformin and 8.3% were using metformin plus enclamide [15]. In the article by [PERSON], a positive attitude towards diabetes self-management practices was observed, with 20% self-monitoring their blood glucose levels. Their understanding of the importance of foot care and diabetes management was poor. A total of 20% of the patients acknowledged having a healthy diet, and 24% practiced physical exercise. Moreover, 56% of patients took medications, 36% used insulin alone, 36% took oral antidiabetic drugs and 28% used insulin plus metformin. Most adhered well to medications. Only 16% performed foot-care practices [16]. In the article by [PERSON], in general, the participants did not control their blood glucose levels on a regular basis, and those who had a glucometer at home reported measuring their sugar once every 4-6 weeks. There was an irregularity in sugar control; they stated that the lack of information and knowledge about the diet was one of the causes of their lack of compliance. In reference to exercise, most admitted not practicing physical exercise on a regular basis.