Study on the current knowledge on diabetic foot care practices and footwear selections among patients attending to the diabetic clinic at Colombo South Teaching Hospital

N T N Wimalarathna,U Bulugahapitiya,C A Jayasuriya

doi:10.4038/sjdem.v11i1.7445

N T N Wimalarathna, U Bulugahapitiya + Show 1 more

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https://doi.org/10.4038/sjdem.v11i1.7445

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Abstract

Introduction: Diabetes foot complications are a leading cause of morbidity and mortality worldwide. Many presents with complicated foot ulcers which end up with amputations. Early interventions and health education significantly reduce such problems. Objectives: To assess the current knowledge on foot care and footwear, to identify the undiagnosed foot problems and risk factors. Methods: In this descriptive cross-sectional study, 334 patients were evaluated for knowledge on foot care and footwear practices by administering 3 questionnaires. Results: The majority were females (73.1%). Mean duration of diabetes was 10.73(+/- 6.9) years. Most patients were non-smokers (78.8%) and non-alcoholics (84.8%). Major comorbidity was dyslipidemia (74.95%). Mean FBS and HbA1c were 137.7mg/dl (+/-43.29) and 7.66% (+/-0.78) respectively. Majority (64%) of them were within moderate risk for diabetic foot disease and 24% had history of foot ulcers. Deformed, thickened and discoloured nails were seen among 42.2%, 38% and 28.7% respectively. Peripheral neuropathy present in 35.6%. Even though 79.8% of the participants washed and 45.8% examined their feet daily, poor foot hygiene was seen among 44.9%. The majority used unsuitable footwear (70.7%). Only 9.6% wore special footwear for diabetes. Most denied adequate knowledge on footwear (80.5%). Nearly half (50.9%) of the population used footwear for > 1 year and 79.3% were not inspecting footwear. Increased age and duration of diabetes, low education, history of foot ulcer, smoking, thickened nails, calluses were significantly associated with diabetic foot (p Conclusion: This study highlighted the gaps in the knowledge and practices of foot care and footwear among diabetic patients. Thus, there is a need to enhance patients’ knowledge with a regular assessment to enforce healthy practices to minimize diabetic foot complications.

Highlights

Diabetes foot complications are a leading cause of morbidity and mortality worldwide
This study highlighted the gaps in the knowledge and practices of foot care and footwear among diabetic patients
According to a Sweden study females were active in self, and preventive foot care measures searched for information and tried to adapt to the situation in acute foot problems

Summary

Introduction

Diabetes foot complications are a leading cause of morbidity and mortality worldwide. Many presents with complicated foot ulcers which end up with amputations. Interventions and health education significantly reduce such problems. Diabetes mellitus is one of the major chronic, a non-communicable disease with disabling long-term complications and the prevalence is rising globally [1]. Impaired production or inadequate utilization of insulin due to resistance is the pathophysiology of hyperglycemia[2]. Inadequate glycemic control will lead to macro and microvascular complications[1,2]. Asian diabetes patients are more prone to get neuropathy and foot problems[3]. A significant number developed such complications even before the diagnosis of diabetes [3,4]. The overall global mortality rate is roughly 5.2% [6]

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