Abstract
Diabetic foot complications are a major challenge for the healthcare system, with enormous economic consequences for the patients, their families, and the society and a leading cause of mortality and morbidity in developing countries. Diabetic foot ulcer (DFU) is the most costly and devastating complication, which affects 15% of diabetic patients during their lifetime. Good knowledge, attitude, and practice regarding diabetic foot care will reduce the risk of diabetic foot complications and ultimately amputations. The aim of this study was to assess the knowledge, attitude, and practice of foot care among type 2 diabetic patients and to determine the relationship between proper foot care and diabetic foot lesions. This is an observational, descriptive, cross-sectional, hospital- based study. It was conducted in the diabetic out-patient clinic at Al-Ribat University Hospital, in Khartoum, Sudan 2016. A total number of 156 type 2 diabetic patients were enrolled in this study; with 75% of the participants were females and 25% males. Duration of DM, exercise, smoking adherent to diabetic diet, type of therapy, co-morbidity, foot lesions, and foot care knowledge, attitude, and practice were tested. Having diabetes longer than 10 years were 37.8%, mean age was 53.4 ± 7.68 years. There was high prevalence of peripheral neuropathy(PN) symptoms 56.4% while 42.3% of the patients had peripheral arterial disease symptoms .17 patients had loss of sensation while only 2 patients had loss of peripheral pulses (dorsalis pedis and posterior artery pulses). Regarding knowledge, attitude, and practice about diabetic foot care, 56.5% had good foot care knowledge, 70.5% had bad attitude, and 62.2% had moderate practice. Based on Chi square test of relationship between proper foot care and diabetic foot ulcer (DFU), there was association between bad knowledge, attitude, and practice about foot care and DFU, P. values: 0,03, 0,000, 0.036 respectively. Advising the diabetics about frequent foot care clinic visits, regular feet examination, proper footwear, exercise program, and smoking cessation would be beneficial in preventing diabetic foot complication. Policy and decision makers should initiate interventional foot care education programs throughout the country, with our ultimate goal is to save limbs.
Highlights
IntroductionDiabetic foot disease is one of the most common and distressing complications that affect diabetic patients .It is a major challenge for the healthcare system ,leading to enormous economic consequences for diabetic patients ,their families ,and government.[1][2]
Diabetic foot disease is one of the most common and distressing complications that affect diabetic patients .It is a major challenge for the healthcare system,leading to enormous economic consequences for diabetic patients,their families,and government.[1][2].Diabetic foot disease accounts for 20% of all hospitalizations of type 2 diabetes patients in sub-Saharan Africa, and frequently leads to chronic disabilities, loss of income, lower limb amputation and death. [2][3][4][5]
Diabetes mellitus is a group of metabolic diseases resulting from defects in insulin secretion, insulin action, 1- Symptoms Plus Random blood glucose level ≥1 mmol/l (≥ 200 mg/dl)
Summary
Diabetic foot disease is one of the most common and distressing complications that affect diabetic patients .It is a major challenge for the healthcare system ,leading to enormous economic consequences for diabetic patients ,their families ,and government.[1][2]. The prevalence of DFU among the population of nerves ,blood vessels and heart [18] It is affecting people worldwide and it is one of the most challenging health problems in the 21 century. Lavery et al.[17] noted a reduction in hospitalizations and amputations in their study ,which developed a lower extremity disease management program that included lower limb screening and treatment protocols for the at – risk foot within a health care facility. Long- term complications of diabetes include retinopathy with potential loss of vision; nephropathy leading renal failure; peripheral neuropathy with risk of foot ulcer, amputations, Charcot joints; an autonomic neuropathy causing gastrointestinal, genitourinary, and cardiovascular symptoms and sexual dysfunction.
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