The Combination of Insulin Therapy and Diabetic Foot Exercises in Reducing Blood Glucose Levels and Improving Peripheral Perfusion in a Patient with Type 2 Diabetes Mellitus: A Case Report
DOI:
https://doi.org/10.56127/jukim.v5i03.2823Keywords:
Keywords: Type 2 diabetes mellitus; Blood glucose; insulin; Peripheral perfusion; Diabetic foot exercisesAbstract
Type 2 diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to insulin resistance and impaired insulin secretion. Poor glycemic control may increase the risk of peripheral vascular disorders, neuropathy, diabetic foot ulcers, and lower-extremity complications. In addition to insulin therapy, diabetic foot exercises may support glucose utilization, improve peripheral circulation, and enhance lower-limb perfusion. This study used a case report design with a nursing care process approach involving a 62-year-old female patient diagnosed with type 2 diabetes mellitus. The intervention consisted of prescribed insulin therapy and diabetic foot exercises performed once daily for seven consecutive days. Random blood glucose levels and Ankle Brachial Index values were measured before and after the intervention to evaluate changes in glycemic control and peripheral perfusion. The findings showed a gradual reduction in random blood glucose levels from 226 mg/dL on the first day to 169 mg/dL on the seventh day. The Ankle Brachial Index also increased from 0.77 to 0.87, indicating improved peripheral perfusion. These changes suggest that combining insulin therapy with diabetic foot exercises may support glucose metabolism and enhance blood flow in the lower extremities. The combination of insulin therapy and diabetic foot exercises may be considered a complementary nursing intervention to improve glycemic control and peripheral perfusion in patients with type 2 diabetes mellitus.
References
Abbas, Q., Latif, S., Ayaz Habib, H., Shahzad, S., Sarwar, U., Shahzadi, M., Ramzan, Z., & Washdev, W. (2023). Cognitive behavior therapy for diabetes distress, depression, health anxiety, quality of life and treatment adherence among patients with type-II diabetes mellitus: A randomized control trial. BMC Psychiatry, 23(1), 86. https://doi.org/10.1186/s12888-023-04546-w
Ahmad, A. M., Mohammed, A. A., Khalifa, W. A., Ali, H. M., & Abdel-Aziz, A. (2024). Effect of Buerger-Allen exercise on wound healing in patients with diabetic foot ulcers: A randomised controlled trial. Journal of Wound Care, 33(Suppl. 4a), xci–xcviii. https://doi.org/10.12968/jowc.2024.33.Sup4a.xci
Amaravadi, S. K., Maiya, G. A., K, V., & Shastry, B. A. (2024). Effectiveness of structured exercise program on insulin resistance and quality of life in type 2 diabetes mellitus: A randomized controlled trial. PLOS ONE, 19(5), e0302831. https://doi.org/10.1371/journal.pone.0302831
Ardiani, H. E., Astika, T., & Permatasari, E. (2021). Obesitas, pola diet, dan aktifitas fisik dalam penanganan diabetes melitus pada masa pandemi Covid-19. Muhammadiyah Journal of Nutrition and Food Science, 2(1), 1–12. https://doi.org/10.24853/mjnf.2.1.1-12
Astuti, D., & Hartutik, S. (2023). Penerapan senam kaki terhadap penurunan kadar glukosa darah pada pasien diabetes mellitus tipe II. INDOGENIUS, 2(1), 8–16. https://doi.org/10.56359/igj.v2i1.103
Balqis, C., Alamsah, M. S., Utami, T., & Alamsyah, A. Z. (2025). Health science journal. Health Science Journal, 16(2), 298–304. https://doi.org/10.34305/afjppr59
Cruvinel-Júnior, R. H., Ferreira, J. S. S. P., Veríssimo, J. L., Monteiro, R. L., Silva, É. Q., Suda, E. Y., & Sacco, I. C. N. (2024). Affordable web-based foot-ankle exercise program proves effective for diabetic foot care in a randomized controlled trial with economic evaluation. Scientific Reports, 14(1), 16094. https://doi.org/10.1038/s41598-024-67176-6
Davies, M. J., Aroda, V. R., Collins, B. S., Gabbay, R. A., Green, J., Maruthur, N. M., Rosas, S. E., Del Prato, S., Mathieu, C., Mingrone, G., Rossing, P., Tankova, T., Tsapas, A., & Buse, J. B. (2022). Management of hyperglycaemia in type 2 diabetes, 2022: A consensus report by the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia, 65(12), 1925–1966. https://doi.org/10.1007/s00125-022-05787-2
Ferreira, J. S. S. P., Cruvinel-Júnior, R. H., da Silva, E. Q., Veríssimo, J. L., Monteiro, R. L., Duarte, M., Giacomozzi, C., & Sacco, I. C. N. (2024). Effectiveness of a web-based foot-ankle exercise program for treating ulcer risk factors in diabetic neuropathy in a randomized controlled trial. Scientific Reports, 14(1), 27291. https://doi.org/10.1038/s41598-024-78188-7
Gholami, F., Naderi, A., Saeidpour, A., & Lefaucheur, J. P. (2024). Effect of exercise training on glycemic control in diabetic peripheral neuropathy: A GRADE assessed systematic review and meta-analysis of randomized-controlled trials. Primary Care Diabetes, 18(2), 109–118. https://doi.org/10.1016/j.pcd.2024.01.008
Hernando-Garijo, I., Medrano-de-la-Fuente, R., Mingo-Gómez, M. T., Lahuerta Martín, S., Ceballos-Laita, L., & Jiménez-Del-Barrio, S. (2024). Effects of exercise therapy on diabetic neuropathy: A systematic review and meta-analysis. Physiotherapy Theory and Practice, 40(9), 2116–2129. https://doi.org/10.1080/09593985.2023.2227975
International Diabetes Federation. (2025). IDF diabetes atlas. International Diabetes Federation.
Introduction and methodology: Standards of care in diabetes—2024. (2023). Diabetes Care, 47(Suppl. 1), S1–S4. https://doi.org/10.2337/dc24-SINT
Jatmiko, S. A. (2024). Senam kaki sebagai upaya peningkatan Ankle Brachial Index (ABI) pada pasien diabetes melitus tipe 2: Laporan kasus. Journal of Health and Cardiovascular Nursing, 4(1), 42–49. https://doi.org/10.36082/jhcn.v4i1.1650
Monteiro, R. L., Ferreira, J. S. S. P., Silva, É. Q., Donini, A., Cruvinel-Júnior, R. H., Veríssimo, J. L., Bus, S. A., & Sacco, I. C. N. (2020). Feasibility and preliminary efficacy of a foot-ankle exercise program aiming to improve foot-ankle functionality and gait biomechanics in people with diabetic neuropathy: A randomized controlled trial. Sensors, 20(18), 5129. https://doi.org/10.3390/s20185129
Novaković-Bursać, S., Talić, G., Tomić, N., Škrbić, R., & Soldatovic, I. (2024). Effect of three-week exercise program on muscle strength and joint mobility in patients with diabetic polyneuropathy: Randomized controlled trial. World Journal of Diabetes, 15(12), 2311–2321. https://doi.org/10.4239/wjd.v15.i12.2311
Rudini, D., Sari, L. A., & Sulistiawan, A. (2026). Impact of diabetic foot exercise on Ankle-Brachial Index in patients with diabetes. International Archives of Medical Sciences and Public Health, 7(1), 41–49. https://doi.org/10.53806/iamsph.v7i1.1389
Schleicher, E., Gerdes, C., Petersmann, A., Müller-Wieland, D., Müller, U. A., Freckmann, G., Heinemann, L., Nauck, M., & Landgraf, R. (2022). Definition, classification and diagnosis of diabetes mellitus. Experimental and Clinical Endocrinology & Diabetes, 130(Suppl. 1), S1–S8. https://doi.org/10.1055/a-1624-2897
Vrátná, E., Husáková, J., Jarošíková, R., Dubský, M., Wosková, V., Bém, R., Jirkovská, A., Králová, K., Pyšková, B., Lánská, V., & Fejfarová, V. (2022). Effects of a 12-week interventional exercise programme on muscle strength, mobility and fitness in patients with diabetic foot in remission: Results from BIONEDIAN randomised controlled trial. Frontiers in Endocrinology, 13, 869128. https://doi.org/10.3389/fendo.2022.869128
Zhu, J., Hu, Z., Luo, Y., Liu, Y., Luo, W., Du, X., Luo, Z., Hu, J., & Peng, S. (2024). Diabetic peripheral neuropathy: Pathogenetic mechanisms and treatment. Frontiers in Endocrinology, 14, 1265372. https://doi.org/10.3389/fendo.2023.1265372
