Cultura

Administrative And Epidemiological Perspectives On Diabetes: Integrating Nursing And Oral Health Services Into Health Systems

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Saeed Abdulrahman Alqahtani, Abdullah Marzoog Alghawazi, Fahad Saleh Almadani, Majed Aedh Alqahtani, Faisal Saeed Alsaedi
Mohamed Faisal Alanazi, Hasan Mohammed Asseri, Abdulrahman Ali Alqahtani, Sultan Awadh Almutairi, Wessam Yousef Alraddadi

Abstract

Diabetes mellitus is a rapidly growing global public health challenge with profound epidemiological and administrative implications for health systems. The increasing prevalence of diabetes, coupled with its chronic course and multisystem complications, has placed sustained pressure on healthcare services and highlighted the limitations of fragmented, physician-centered care models. From an epidemiological perspective, diabetes represents a long-term population-level burden that requires coordinated planning, prevention strategies, and continuous management rather than episodic clinical intervention.

This narrative, policy-oriented review examines diabetes from an administrative and epidemiological perspective, with particular emphasis on the integration of nursing and oral health services into health system–based diabetes management pathways. Drawing on evidence from international epidemiological reports, health policy documents, and peer-reviewed literature, the review explores how epidemiological data can inform administrative decision-making, workforce organization, and service integration.

The findings demonstrate that nursing services play a critical role in operationalizing diabetes care through patient education, monitoring, continuity of care, and translation of epidemiological evidence into routine practice. Additionally, strong epidemiological evidence supports the bidirectional relationship between diabetes and periodontal disease, underscoring the need to integrate oral and dental health services into diabetes management frameworks. However, administrative separation between medical, nursing, and dental services remains a major barrier to coordinated care in many health systems.

The review concludes that epidemiology-informed health administration provides a robust framework for integrating nursing and oral health services into diabetes care pathways. Such integration has the potential to improve clinical outcomes, enhance system efficiency, and support sustainable health system responses to the growing diabetes burden. Policymakers and health administrators are encouraged to adopt integrated, multidisciplinary models of diabetes care grounded in epidemiological evidence and health system strengthening principles.

Keywords : Diabetes mellitus; Epidemiology; Health administration; Nursing services; Oral health; Dental care; Integrated care; Health systems; Chronic disease management.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty