Rincy Sajith ¹ Louise Ackers ¹ Simona Ackers-Johnson ² Daniel Parker ¹ Melanie Stephens ^1*

• ¹ University of Salford, Salford, North West England, United Kingdom
• ² Wears River Trust, Durham, United Kingdom

Objective: To assess the scope of existing practice, nature and impact of nurse-led Type 2 diabetic foot prevention services and educational programmes in Sub-Saharan Africa (SSA).Introduction: Type 2 diabetes mellitus (T2DM) in SSA imposes a heavy burden on current healthcare services. Complications such as foot ulcers create significant costs to patients and healthcare resources. Identifying patients at risk of developing diabetic foot complications and empowering them through diabetes self-management education and support from specialist foot clinics is crucial. However, the availability of such programmes and services in SSA is limited.Inclusion criteria: Studies of nurse led diabetic foot prevention services and/or educational programmes in low to middle income countries in SSA for adults with T2DM, written in English Language, between August 2013 and March 2024 were considered.Methods: Following the standard PRISMA guidelines for conducting and reporting scoping reviews searches were conducted on four electronic databases (CINAHL, ProQuest, MEDLINE and Scopus) and google scholar. Titles and abstracts were screened. All eligible papers were retrieved for full text screening.Ten studies (across 14 papers) were included in the review and all focused-on nurse-led DSME programmes in SSA. There are no specific educational programmes or services led by nurses focussing solely on diabetic foot prevention. Analysis highlighted the components of successful nurse led DSME's that led to positive glycaemic control and selfcare behaviours include: the focus is on behaviour change and the DSME should be coproduced with service users. Theoretical aspects of the DSME are evidence based, structured, interactive, culturally and linguistically appropriate group-based activities. The DSME should be delivered over a period of weeks and sessions should last between 1.5-2hours. Barriers to delivery and participation include the rainy season, stock outs, time and resources needed and a DSME that meets varied levels of literacy and education.There is a heightened need to create nurse-led, co-produced, culturally congruent, frugal, and sustainable education interventions or programmes. There is also a need for diabetic foot screening and foot ulcer prevention services that can run sustainably along with these educational interventions using task shifted, simple, and frugal initiatives.