OBJECTIVE: To compare hemoglobin A1c (HbA1c) levels and ankle brachial index (ABI) in older adults with type 2 diabetes mellitus (T2DM) between the experimental group and the control group two months after receiving the foot reflexology program, and to compare HbA1c levels and ABI in older adults with T2DM in the experimental group before and two months after receiving the foot reflexology program.

MATERIALS AND METHODS: A randomized experimental design with a randomized controlled two-group pretest-posttest design. The purpose of the study was to investigate the effects of foot reflexology integrated with medication use on HbA1c and ABI in older adults with T2DM who sought treatment at the diabetes clinic of Manorom Hospital, Manorom District, Chai Nat Province. The study sample consisted of 40 older adults with T2DM who sought treatment at the diabetes clinic who met the inclusion criteria. The subjects were recruited through random sampling, with 20 assigned into the experimental group and the other 20 into the control group. The subjects in the experimental group received foot reflexology every day for a period of two months, while those in the control group did not receive such treatment. All of the subjects in both groups received pharmacological treatment of diabetes with either oral medication or insulin injection as prescribed in the treatment plan based on their measurements with HbA1c used the ARRAY High Performance Liquid Chromatography (HPLC), and ABI level use the doppler ultrasound with handheld doppler probe. Data were analyzed using inferential statistics, Independent t-test and Paired t-test.

RESULTS: The results revealed that after receiving foot reflexology, the HbA1c of the experimental subjects was lower than that of the control subjects (t = 2.76, p = 0.009, SD = 1.37). In addition, their ABI levels in the right leg and left leg were higher than those of the control subjects (t = 5.921, p < 0.001, SD = 0.044 and t = 9.155, p = < 0.0001, SD = .016 respectively). Also, after receiving foot reflexology, the subjects in the experimental group had lower HbA1c (t = 10.54, p < 0.001, SD = 0.96) and ABI levels in their right leg and left leg (t = -8.475, p < 0.001, SD = 0.044 and t = -10.249, p < 0.001, SD = 0.060 respectively).

CONCLUSION: Foot reflexology can reduce HbA1c and increase ABI in older adults

with T2DM. It can be implemented as a complementary therapy to control diabetes and

reduce severity of complications of diabetic foot in older adults with T2DM.