Abstract
ObjectiveThe goal of this study was to evaluate foot-care practices by physicians throughout India who had participated in the Diabetic Foot Education Program (DFEP).MethodsA structured questionnaire was administered to physicians throughout India, and their responses were analyzed descriptively.ResultsA total of 377 doctors responded to the DFEP opinion survey, including 261 doctors who belonged to independent diabetic foot clinics. Of these doctors, 44.4% reported managing fewer than five diabetic foot patients per week and 42.8% reported managing 5-10 patients per week. Most of these patients had non-ischemic foot, followed by those with ischemic and Charcot foot. About 58% of these physicians reported performing comprehensive clinical examinations and providing optimal preventive and therapeutic care in the treatment of diabetic foot, whereas only 25.7% reported performing only callus removal and changing dressings. Basic instruments to manage diabetic foot included the monofilament, tuning fork, biothesiometer, handheld Doppler, and pedometer, which were used by 76%, 75.5%, 59.5%, 27.7%, and 12.8% of doctors, respectively. The most common comorbidities were neuropathy, reported by 333 doctors, followed by peripheral vascular disease, reported by 297 doctors. Tools for diabetic foot education included posters in the clinic, used by 75% of doctors; pamphlets, used by 56.2%; videos, used by 45.2%; and diabetic foot applications, used by 36.7% of doctors.ConclusionsThere is a need to promote diabetic foot awareness and implement foot-care strategies to prevent diabetic foot and effectively manage this condition. Diabetic foot education programs will encourage clinicians to effectively use diagnostic tools for assessment and management of diabetic foot and to establish independent diabetic foot clinics.
Highlights
An estimated 463 million adults are living with diabetes; India, with 77 million patients, has the second-highest number of patients after China [1]
A total of 377 doctors responded to the Diabetic Foot Education Program (DFEP) opinion survey, including 261 doctors who belonged to independent diabetic foot clinics
44.4% reported managing fewer than five diabetic foot patients per week and 42.8% reported managing 5-10 patients per week
Summary
An estimated 463 million adults are living with diabetes; India, with 77 million patients, has the second-highest number of patients after China [1]. Treating diabetic foot ulcers is costly, accounting for 20% of total healthcare costs for diabetes, which is more compared to the cost for any other diabetic complication [3]. In India, the numbers of diabetic foot patients are increasing in both urban and rural settings, with 85% of amputations preceded by foot ulcers. In India, neuropathic lesions account for 80% of foot ulcers, with neuroischemic making up the remaining 20% [4]. The prevalence of the peripheral arterial disease is 3.2% in diabetic patients aged 80 years, with the increase being associated with both age and the duration of diabetes [5]. In India, approximately 100,000 legs are amputated every year, and the numbers are increasing [3]
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