IDF21-0391 Foot Self-care Practices among People Living with Type 2 Diabetes Mellitus: A Community-based Cross-sectional Study

Abstract

Background: In India, the prevalence of diabetes is increasing at an alarming rate, so is the prevalence of mortality and morbidity due to its complications. Problem-related to the foot is neglected amongst complications of diabetes and the most common cause of hospitalization among people living with type 2 diabetes mellitus (T2DM). Therefore, education regarding the importance of foot care practice among people living with diabetes is very vital. Aim: The main aim of the study was to assess foot self-care practices and determine factors affecting foot self-care activity among people living with T2DM. Method: A community-based cross-sectional study was conducted among 700 people living with T2DM from July 2019 to December 2019 in the district Fatehgarh Sahib, Punjab, India. Multistage random sampling was used for the selection of the sampling area and a consecutive sampling technique was applied to recruit eligible participants from the selected areas. Pre-validated and structured questionnaires were administered based on recommendations of the International Working Group on the Diabetic Foot (IWGDF) and American Diabetes Association (ADA) along with Nottingham Assessment of Functional Footcare (NAFF) to score the foot care practices among people living with T2DM. The foot care practices were classified into three categories: if the score was <50% of the maximum possible score of 84, foot care practices was considered poor, if the score was 50%-70% of the maximum possible score of 84, then it was appraised as satisfactory foot care and if the score was >70% of the maximum possible of 84, then it was regarded as good. Results: Total 700 people living with T2DM were assessed for foot self-care practices in the study. Out of which 233 (33%) were males and 467 (67%) were females. The mean (SD) age was 55 years (± 10 years) and 2/3 of the participants were literate. The median duration (IQR) of diagnosed with T2DM was 4 years (IQR:3years -7years). Few proportions (13%) of respondents received foot care education from their treating physician, while only 6% of the participants underwent foot examination by the treating physician. Overall, diabetes foot self-care practices were poor among 84% (588) of the respondents, while 16% (112) participants have satisfactory performance and none were in the good category. Factors in multivariable logistics regression namely female gender, literate, low socioeconomic status, nuclear family, uncontrolled blood glucose level and participants who had received foot care advice from their treating physician were demonstrated significant better foot self-care practices (p-value <0.05). Discussion: The study results highlighted that foot self-care practices among people living with T2DM was alarmingly low and there is an urgent need to start a comprehensive diabetes management clinic in both primary and secondary health care levels to avert the consequences of the rapidly rising prevalence of diabetes and its related complications.