Foot-related Problems Research Articles

What's the Impact of Safety Footwear on Workers Concerning Foot-Related Problems? A Systematic Review.

This study aims to assess the impact of safety footwear (SF) on workers concerning foot-related problems, especially regarding discomfort, foot pain, and skin lesions. A literature search of PubMed, Embase, Scopus, and Cochrane databases was performed according to PRISMA guidelines. Studies reporting foot-related problems in workers wearing SF were included. Exclusion criteria included non-English papers, reviews, laboratory and animal studies, expert opinions, letters to the editor, and grey literature. The quality assessment was performed using the Newcastle-Ottawa Scale. Descriptive statistic was used to present data. The initial search results yielded 483 articles; 7 articles were included in the review process. Despite the extensive variety of SF, all studies consistently reported symptomatic discomfort and pain. The discomfort factors included heat, sweating, heaviness, and footwear flexibility, with primary issues in the toes, toecaps, or metatarsal-toe crease region. The pain prevalence ranged from 42.3% to 60.8% in various anatomical regions. Irritant Contact Dermatitis was the most common (97.9%) foot dermatosis, but other foot lesions were reported: dry skin (30.2%), calluses (30%), hard nails (28%), corns (27%), and blisters. Current SFs are designed to comply with safety regulations but are influenced by the frequent occurrence of discomfort and foot problems. The literature review identified weaknesses in certain design features. Recommendations have been proposed to improve SF development. These include addressing issues such as the selection of specific types and designs of SF based on task performance and the working environment, footwear weight, and breathable materials for moisture permeation. Considerations should also encompass distinct sizing for an optimal fit, insole application, especially for prolonged standing users, and education programs to prevent foot-related issues.

Do the feet of male and female netball players differ in shape? Implications for shoe design

ABSTRACT A large proportion of netball players suffer foot-related problems and pain and are dissatisfied with current netball-specific footwear. To improve the fit and functionality of netball-specific shoes, we must understand the shape of these players’ feet and determine whether any sex differences exist. Five hundred and two representative-level netball players (n = 251 male; n = 251 female) had their feet three-dimensionally scanned. We then used a validated MATLAB code to automatically extract 10 measurements to characterise each participant’s foot shape. Differences between men and women for the absolute values and those normalised to foot length and stature were identified using independent samples t-tests with a Bonferroni adjusted alpha level. The size and shape of male netball players’ feet differed significantly from their female counterparts. Males had significantly larger absolute and normalised foot measurements than females, notably at the ball of the foot, heel and instep (p < 0.001). Netball shoe manufacturers should develop unique lasts for each sex and foot size and should offer a more extensive range of shoe lengths and widths to netball players. Such considerations will help optimise shoe fit and comfort and, in turn, reduce foot-related problems and pain associated with ill-fitting footwear.

Risk factors of knee reinjury after anterior cruciate ligament reconstruction.

This study aimed to investigate whether the return to level I sports, concomitant injuries, foot-related problems, and other factors would increase the risk of knee reinjury after anterior cruciate ligament reconstruction (ACLR). This study used a prospective cohort study design. Online enrolment from August 2018 to January 2019 in ACL Community Indonesia recruited 148 patients who had undergone ACLR less than one month prior to injury. Knee injury occurrence after ACLR was diagnosed through a physical examination and positive MRI or arthroscopic findings. During the study, 55 knee reinjuries occurred. The proportional hazards model analysis revealed that the risk of knee reinjury at 12 and 24 months for patients who returned to level I sports (hazards ratio (HR)=3.17 and HR=3.90, respectively) was significantly higher than that of the patients who did not return to sports and that the risk for those who returned to level II/III sports did not significantly increase at 12 or 24 months. Patients with concomitant meniscus injury had a significantly higher risk of knee reinjury at 12 and 24 months (HR=3.33 and HR=2.25, respectively) than those without, and the risk of knee reinjury for patients with concomitant posterior cruciate ligament injury was significantly higher at 12 months (HR=3.05) but not at 24 months. Fewer knee symptoms after ACLR were significantly associated with a lower risk of knee reinjury (HR=0.98) at 12 and 24 months. The return to level I sports, concomitant meniscus and posterior cruciate ligament injury, and knee symptoms after ACLR may increase the risk of knee reinjury for post-ACLR patients.

Adherence to diabetic foot care recommendations and associated factors among people with diabetes in Eastern Ethiopia: a multicentre cross-sectional study

ObjectiveThis study aimed to determine the level of adherence to foot care recommendations and associated factors among people with diabetes on follow-up in public hospitals in Eastern Ethiopia.SettingAn institutional-based cross-sectional...

Prevalence of foot posture deformities using foot posture index in various intensive care unit nurses

Background: This study aims to determine the prevalence of foot posture deformities among various intensive care unit nurses using the Foot Posture Index. Nurses working in ICUs often face long hours of standing and walking, which can contribute to the development of foot-related problems. Understanding the extent of these deformities can contribute to the development of preventive measures, such as ergonomic interventions and targeted exercises, to mitigate the risk of foot-related issues. Methods: A study was conducted among 159 nurses from various Intensive Care Units. The Foot Posture Index, a validated tool for assessing foot posture was used to assess foot deviations in nurses. Results: In total159 participants were evaluated, with 6 (4%) being males and 153 (96%) being females. The mean age of the participants was (Mean=40.67) and standard deviation (SD=9.6). Prevalence percentage of foot posture deviations were found to be bilateral as demonstrated by Foot Posture Index. Out of 159 participants 43% participants had pronated foot, 14% participants had highly pronated foot, 16% participants had supinated foot, 7% had normal highly supinated foot posture and 20% participants had normal foot. Conclusions: To conclude the present study, pronated foot posture was the most common foot deviation. Moreover, when BMI was compared with the pronated foot deviation, there was a positive association between pronated foot and the nurses who were overweight.

Diabetic Foot Care: Knowledge and Practice – A Cross-sectional Study from a Tertiary Care Hospital in Southern India

Background: Diabetes mellitus is one of the major problems in health systems and a global public health threat and diabetic foot ulcers and lower extremity amputations are common, complex, costly, and disabling complications of diabetes. Poor foot care knowledge and practices are important risk factors for foot-related problems among diabetic people. Aims: The aim of the study is to assess the knowledge about foot care, foot care practices, the prevalence and risk factors of diabetic foot and foot-related complications in adult diabetic patients. Settings and Design: The cross-sectional study was conducted in 204 consecutive diabetic patients attending the outpatient department of a tertiary care hospital. Methods: A questionnaire including demographic details, knowledge questionnaire, attitude, and awareness for foot problems based on the Nottingham Assessment of Functional Foot Care Revised 2015 questionnaire was administered. This was followed by a foot examination for various aspects related to foot care and risk stratification. Statistical Analysis Used: Descriptive analysis with frequency distribution for knowledge and practice scores, univariate analysis, and multiple logistic regressions to find significant variables associated with good foot care knowledge and practice scores. Results: About 30.39% had good knowledge score. Rural background (adjusted odds ratio [OR]: 1.98, 95% confidence interval [CI]: 1.08–3.65), poor education status (adjusted OR: 4.63, 95% CI: 1.04–20.54), poor glycemic control (adjusted OR: 1.46, 95% CI: 0.83–2.58), and previous history of foot ulcer (adjusted OR: 3.05, 95% CI: 1.42–6.65) were significantly associated with poor knowledge on foot care. Conclusion: Our study shows that knowledge and practice of foot care of diabetic patients are still substandard. Poor communication between patients and nurses/physicians, rural background, poor education, and poor glycemic control were significant barriers of foot care. Policymakers should initiate foot care education programs throughout the regional state for increasing awareness about proper foot care practice in diabetic patients to reduce the incidence of complications.

What do male netball players want in their footwear? Design recommendations for netball-specific shoes for men

With the increasing professionalisation of men's netball and the high prevalence of foot-related problems and pain, manufacturers must develop shoes with the correct ergonomic design to meet the unique needs of male netball players. This study aimed to determine what factors men consider when selecting a netball-specific shoe and what design features they want in an ideal netball-specific shoe. 279 amateur, sub-elite and elite male netball players completed a 38-question online survey about their footwear habits and preferences. Support was the most influential factor when men selected a netball-specific shoe. A wider toe-box, more durable upper and outsole, and added cushioning and support in the midsole and insole were preferred fit, form and function features for an ideal netball-specific shoe. We recommend that manufacturers develop a range of netball-specific shoes based on the foot dimensions, playing demands and preferences of male netball players to meet men's fit and functionality requirements.

Effects of Customized 3D-Printed Insoles in Patients with Foot-Related Musculoskeletal Ailments—A Survey-Based Study

The prevalence of individuals with flat feet and high arches is very high (between 15% to 37%), which can often lead to other orthopedic complications. Three-dimensional-printed insoles are being studied and validated for their effects in correcting these highly prevalent foot disorders. Highly customizable parameters while printing the insole allows for precise correction of foot biomechanics. In this study, 200 patients suffering from various foot-related problems and joint pain were given 3d-printed insoles (designed using plantar pressure systems and clinical practitioner’s assessment) to use in their footwear. Tested activities included standing, walking, running, sports, and gym workout. Customization of insoles included custom density, heel cup, heel rise, medial arch height, and lateral wedge. Based on the patient history, additional podiatry elements were provided for patients with diabetes. Each insole was designed as per the insole profile of the shoe with a comfortable fit. These insoles were found to be effective in alleviating pain for more than 90% of the patients and provided a longer life cycle with effective orthotic correction (for &gt;16 months of daily use). This paper presents the post-use effects (6–18 months) of custom 3D-printed insoles.

Foot Problems and Their Associations with Toe Grip Strength and Walking Speed in Community-Dwelling Older Individuals Using Day Services: A Cross-Sectional Study

Foot disorders in older individuals compromise balance and contribute to postural and gait instabilities, causing a decrease in the activities of daily living and quality of life. In this cross-sectional study, we analyzed the foot-related data of 160 frail older participants who attended day service centers in A prefecture in Japan to determine the prevalence of foot problems and their associations with toe grip strength and walking speed in frail older people. Multiple regression analysis was used to identify foot-related variables that correlated with toe grip strength and walking speed. The prevalence rates of skin dryness (Support level 88.2%, Care level 85.2% for men; Support level 84.9%, Care level 93% for women) and suspected and existing fungal infections in nails (Support level 94.1%, Care level 92.6% for men; Support level 98.1%, Care level 95.2% for women) were high in both sexes regardless of the level of care required. Furthermore, in both sexes, the prevalence rates of toe and arch deformities were significantly increased in the people who required care. Regression analysis revealed that some right-sided foot-related problems were significantly associated with right toe grip strength and walking speed. The decrease in toe grip strength was significantly associated with walking speed. Our study provides evidence that some specific conditions were associated with toe grip force and walking speed. This finding can contribute to future strategies to protect foot health in community-dwelling older individuals.

Cross-cultural adaptation and validation of a Spanish version of the self-administered foot evaluation questionnaire (SAFE-Q)

BackgroundThe self-administered foot evaluation questionnaire is a comprehensive measure for assessing the perception of patients regarding their foot-related problems. However, it is currently only available in English and Japanesse. Therefore, this study aimed to cross-culturally adapt the questionnaire to Spanish and assess its psychometric properties. MethodsThe methodology recommended by the International Society for Pharmaco Economics and Outcomes Research for translating and validating patient-reported outcome measures was followed for the Spanish translation. After a pilot study with 10 patients and 10 controls, an observational study was carried out between March and December 2021. The Spanish version of the questionnaire was filled by 100 patients with unilateral foot disorders, and the time spent to complete each questionnaire was recorded. Cronbach's alpha was calculated to analyze the internal consistency of the scale and Pearson's correlation coefficients for the degree of inter-subscale associations. ResultsThe maximum correlation coefficient for the Physical Functioning, Daily Living, and Social Functioning subscales was 0.768. The inter-subscale correlation coefficients were significant (p < 0.001). Additionally, the value of Cronbach's alpha for the whole scale was 0.894 (95% confidence interval, 0.858–0.924). The values of Cronbach's alpha varied between 0.863 and 0.889 when the value of one of the five subscales was suppressed, which can be considered a measure of good internal consistency. ConclusionThe Spanish version of the questionnaire is valid and reliable. The method followed for its transcultural adaptation ensured its conceptual equivalence with the original questionnaire. Health practitioners can use the self-administered foot evaluation questionnaire as a complementary method to assess the interventions performed for ankle and foot disorders among native Spanish speakers; however, further research is necessary to assess its consistency for use by populations from other Spanish-speaking countries.

Diabot: Development of a Diabetic Foot Pressure Tracking Device

Foot-related problems are prevalent across the globe, and this issue is aggravated by the presence of diabetes mellitus. Diabetic-foot-related issues include extreme foot pain, plantar corns, and diabetic foot ulcers. To assess these conditions, accurate characterization of plantar pressure is required. In this work, an in-shoe, low-cost, and multi-material pressure measuring insole, based on a piezoresistive material, was developed. The device has a high number of sensors, and was tested on 25 healthy volunteers and 25 patients with different degrees of diabetes. The working range of the device was observed to be 5 kPa to 900 kPa, with an average hysteresis error of 3.25%. Plantar pressure was found to increase from healthy to diabetic volunteers, in terms of both standing and walking. In the case of the diabetic group, the-high pressure contact area was found to strongly and positively correlate (R2 = 0.78) with the peak plantar pressure. During the heel strike phase, the diabetic volunteers showed high plantar pressure on the medial heel region. In regard to the toe-off phase, the central forefoot was found to be a prevalent site for high plantar pressure across the diabetic volunteers. The developed device is expected not only to assist in the prediction of diabetic ulceration or re-ulceration, but also to provide strategies and suggestions for foot pressure alleviation and pain mitigation.

Are male netball players satisfied with the shoes that they wear for netball?

Despite the recent growth of men participating in netball, the footwear needs of male netball players have been largely neglected by researchers and shoe manufacturers. This study aimed to determine whether male netball players were satisfied with the shoes they currently wore for netball and explore the reasons why many men do not wear netball-specific shoes. 279 amateur, sub-elite and elite male netball players completed a 38-question online survey about their footwear habits and foot-related problems. A mixed-methods approach was used to analyse the quantitative and qualitative survey data. Irrespective of shoe type worn, men were dissatisfied with the width fit, durability and breathability of the shoes they currently wore for netball activity. The participants desired to modify the outsole, insole and toe box of the current shoes they wore for netball. Men also identified a diverse range of non-shoe design and shoe design factors related to fit and functionality that deterred them from wearing netball-specific footwear. It is recommended that the fit and functionality of shoes designed for male netball players are improved to better cater for the foot dimensions and netball performance demands of men.

OptiFit: Computer-Vision-Based Smartphone Application to Measure the Foot from Images and 3D Scans

The foot is a vital organ, as it stabilizes the impact forces between the human skeletal system and the ground. Hence, precise foot dimensions are essential not only for custom footwear design, but also for the clinical treatment of foot health. Most existing research on measuring foot dimensions depends on a heavy setup environment, which is costly and ineffective for daily use. In addition, there are several smartphone applications online, but they are not suitable for measuring the exact foot shape for custom footwear, both in clinical practice and public use. In this study, we designed and implemented computer-vision-based smartphone application OptiFit that provides the functionality to automatically measure the four essential dimensions (length, width, arch height, and instep girth) of a human foot from images and 3D scans. We present an instep girth measurement algorithm, and we used a pixel per metric algorithm for measurement; these algorithms were accordingly integrated with the application. Afterwards, we evaluated our application using 19 medical-grade silicon foot models (12 males and 7 females) from different age groups. Our experimental evaluation shows that OptiFit could measure the length, width, arch height, and instep girth with an accuracy of 95.23%, 96.54%, 89.14%, and 99.52%, respectively. A two-tailed paired t-test was conducted, and only the instep girth dimension showed a significant discrepancy between the manual measurement (MM) and the application-based measurement (AM). We developed a linear regression model to adjust the error. Further, we performed comparative analysis demonstrating that there were no significant errors between MM and AM, and the application offers satisfactory performance as a foot-measuring application. Unlike other applications, the iOS application we developed, OptiFit, fulfils the requirements to automatically measure the exact foot dimensions for individually fitted footwear. Therefore, the application can facilitate proper foot measurement and enhance awareness to prevent foot-related problems caused by inappropriate footwear.

Footwear profiles and foot-related problems of male netball players

Introduction: Netball, originally known as ‘women’s basketball’, was initially designed and traditionally administered as a sport exclusively for women. Since the early 1980’s, however, male participation in netball has grown with a 48% and 240% increase in men’s and boy's participation in netball since 2016, respectively. This is the highest growth rate of any adult men’s sport in Australia. Integrating males into a historically female-only sport has raised important questions about the design and fit of netball equipment for males, such as footwear.

Do the Footwear Profiles and Foot-Related Problems Reported by Netball Players Differ Between Males and Females?

IntroductionWe explored the footwear profiles and foot-related problems reported by netball players and whether these differed between males and females.MethodsTwo thousand nine hundred and twenty-five amateur, sub-elite and elite netball players (men n = 279; women n = 2646; age 26.4 ± 10.0 years) completed a custom-designed online survey with questions related to netball experience, current netball footwear habits and history of foot-related problems. Footwear profiles and foot-related problems were considered in logistic regressions against sex and competition level to ascertain significant relationships (p < 0.05) and predictive values (odds ratio).ResultsAlthough 80.4% of respondents reported wearing netball-specific shoes, females were 13.2 times more likely to wear netball-specific shoes than males. Foot-related problems and foot pain were reported by 84.3% and 56.8% of netball players, respectively; with blisters, ankle sprain/strains and calluses being most common. Although women were significantly more likely to suffer from foot-related problems than men, males were significantly more likely to believe their foot pain was caused by the footwear they wore for netball.ConclusionThe high prevalence of foot-related problems and pain reported by all netball players suggests that the shoes players are currently wearing for netball are not meeting the requirements of players, particularly regarding fit, comfort and functionality. As male netball players have significantly different footwear profiles to female players, men are likely to require netball-specific footwear that differs to the netball-specific shoes designed for female players.

Mobile Apps for Foot Measurement in Pedorthic Practice: Scoping Review.

BackgroundAs the use of smartphones increases globally across various fields of research and technology, significant contributions to the sectors related to health, specifically foot health, can be observed. Numerous smartphone apps are now being used for providing accurate information about various foot-related properties. Corresponding to this abundance of foot scanning and measuring apps available in app stores, there is a need for evaluating these apps, as limited information regarding their evidence-based quality is available.ObjectiveThe aim of this review was to assess the measurement techniques and essential software quality characteristics of mobile foot measurement apps, and to determine their potential as commercial tools used by foot care health professionals, to assist in measuring feet for custom shoes, and for individuals to enhance their awareness of foot health and hygiene to ultimately prevent foot-related problems.MethodsAn electronic search across Android and iOS app stores was performed between July and August 2020 to identify apps related to foot measurement and general foot health. The selected apps were rated by three independent raters, and all discrepancies were resolved by discussion among raters and other investigators. Based on previous work on app rating tools, a modified rating scale tool was devised to rate the selected apps. The internal consistency of the rating tool was tested with a group of three people who rated the selected apps over 2-3 weeks. This scale was then used to produce evaluation scores for the selected foot measurement apps and to assess the interrater reliability.ResultsEvaluation inferences showed that all apps failed to meet even half of the measurement-specific criteria required for the proper manufacturing of custom-made footwear. Only 23% (6/26) of the apps reportedly used external scanners or advanced algorithms to reconstruct 3D models of a user’s foot that could possibly be used for ordering custom-made footwear (shoes, insoles/orthoses), and medical casts to fit irregular foot sizes and shapes. The apps had varying levels of performance and usability, although the overall measurement functionality was subpar with a mean of 1.93 out of 5. Apps linked to online shops and stores (shoe recommendation) were assessed to be more usable than other apps but lacked some features (eg, custom shoe sizes and shapes). Overall, the current apps available for foot measurement do not follow any specific guidelines for measurement purposes.ConclusionsMost commercial apps currently available in app stores are not viable for use as tools in assisting foot care health professionals or individuals to measure their feet for custom-made footwear. Current apps lack software quality characteristics and need significant improvements to facilitate proper measurement, enhance awareness of foot health, and induce motivation to prevent and cure foot-related problems. Guidelines similar to the essential criteria items introduced in this study need to be developed for future apps aimed at foot measurement for custom-made or individually fitted footwear and to create awareness of foot health.

Community-Dwelling Older Individuals Using Day Services: Prevalence and Associations between Walking, Toe-Grip Strength, and Foot Problems

Background: Foot disorder in older individuals contributes to balance, posture and gait instability, leading to a decrease in activity of daily living and quality of life. However, the existing foot problems of older individuals in the community are not extensively studied in Japan. Method: This cross-sectional study analyzed the foot-related data of 176 frail, old-aged participants who attended day service centers in Japan. Foot conditions were assessed and measured from various aspects, as was weight distribution to the floor. Multiple regression analysis was used to find foot item variables that correlated with toe-grip strength and walking speed. Findings: Prevalence of skin dryness and suspected and existing nail fungal infection was high in both sexes regardless of care level. Prevalence rate of toe deformity and arch deformity was significantly higher in men and women requiring long-term care, respectively. Regression analysis revealed that some right-side foot-related problems were significantly associated with right toe-grip strength and walking speed. Toe-grip strength and walking speed had statistically significant association. The participants’ weight distribution to the floor was greater on the right side than on the left. Interpretation: Our study supported that individuals requiring more long-term care tend to have more foot problems. Some specific conditions were associated with toe-grip force and walking speed. This finding contributes to future strategies to protect foot health for community-dwelling older individuals, particularly the frail population. Funding Statement: The questionnaire development and data collection and analysis were funded by Grants-in-Aid for Scientific Research (No. 19K11111). Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: The Ethics Committee of the Human Environments University (2019N-002) and Nagoya University (2019-0150) approved this study. This study was conducted in accordance with the Helsinki Declaration. Information related to the purpose of the study, privacy, the right to discontinue, and future publication has been included in the cover letter. Consent for study participation was implied by the submission of a completed questionnaire.

Foot care knowledge and practices among Japanese nurses and care workers in home care and adult service center: a cross- sectional study

BackgroundFoot care knowledge and practices among nurses and care workers in the community greatly impact foot health maintenance and prevention of foot-related problems among older people. This study aimed to explore and examine the current foot care knowledge, practices, and perceptions among nurses and care workers at home care and adult day service center, along with their demographic characteristics and daily care for clients.MethodsThis study analyzed 232 randomly selected front-line nurses and care workers working at home care or adult day service center in one of the selected cities, Aichi Prefecture, Japan. Data were obtained using questionnaires and subsequently analyzed using descriptive statistics, t-tests, Chi-square tests, Wilcoxon rank-sum tests, and Spearman’s rank correlation tests.ResultsAmong the 305 surveyed, 232 (62 nurses; 170 care workers) provided data. Although 57 nurses (91.9%) and 142 care workers (83.5%) showed interest in foot care, 33 nurses (53.2%) and 133 care workers (78.2%) stated that foot care education was insufficient. Knowledge and practice scores were associated with working status.Higher accuracy differences in the early detection of foot problems and skin tears on lower limbs in knowledge category were observed between nurses and care workers. The nurses as well as the care workers had low accuracy rates of knowledge questions regarding the use of shoes and socks subscale.For practice, both nurses and care workers had low mean scores for checking client’s shoes (2.0/5.0 and 2.1/5.0, respectively), method for reducing ingrown nail pain (2.6/5.0 and 1.9/5.0, respectively), and opportunity for discussing foot care with others (2.7/5.0 and 2.2/5.0, respectively). A significant correlation between knowledge and practice scores was observed among nurses (0.331, p < 0.05) and care workers (0.339, p < 0.001).ConclusionsDespite the presence of several barriers toward enhanced care delivery to clients needing it most, nurses and care workers clearly understood the importance of foot care. These findings indicate that foot care should be focused by nurses and care workers to improve the knowledge and practice of foot care and to suggest future implications that efficient and understandable tools are needed considering their current working situation.

Diabetic Foot Ulceration in a Secondary Health Facility

Aims: To determine the prevalence, pattern and presentation of the diabetic foot ulcer.&#x0D; Background: A diabetic foot ulcer is a major complication in diabetes mellitus and probably the major component of diabetic foot. It occurs in 15% of all patients with diabetes and precedes 84% of all lower leg amputations.&#x0D; Poverty, low economic status and ignorance have resulted in this devastating disease. It may worsen in the next decade.&#x0D; There are multiple risk factors that predispose an individual to DM foot ulcer; they include age, gender(male), type of DM, glycaemic (HbA1c) or FBG level, duration of DM (&gt;10yrs) occupational status particular habits of self-foot care and infection.&#x0D; Patients and Methods: This consists of 69 diabetic patients; male and female included done between the months of January 2019 to March 2019.&#x0D; A demographic data questionnaire and social history were obtained. Overnight fasting serum glucose was obtained. Serum glucose was determined by enzymatic glucose oxidase method.&#x0D; Data obtained were subjected to Stata Version 11 Software to determine the graphical representation, mean, standard deviation of the analysis.&#x0D; Results: Thirty-Five 35 were male and 34 were female had type 2 diabetes. Forty-Three 43 patients had foot ulcer, 21 patients had gangrene and 5 had infection. The number of patients with peak glucose values 10 mmol/L and least glucose at 20-25 mmol/L. Those of duration 4-6 years were the most affected the age group most affected is between 40-59 yrs.&#x0D; Discussion and Conclusion: Risk factors for foot ulceration discovered among a host other factors identified in this study, were the infection, low socioeconomic status, improper footwear, poor glycaemic control, structural foot deformity and untreated gangrene.&#x0D; The role of poor glycaemic control in the genesis of diabetic complications cannot be overemphasized as the mean FPG was noted to be considerably higher in patients with foot ulceration As part of a comprehensive foot care programme, education on foot care should be directed at patients, family members and healthcare providers.&#x0D; Not less than 85% of all diabetic foot-related problems are preventable. This can be achieved through a combination of good care of foot, provided by an inter-professional diabetes care team, and appropriate education for people with diabetes.

Factors explaining variation in self-esteem among persons with type 1 diabetes and elevated HbA1c.

ObjectivesTo investigate associations between perceived autonomy support from health-care professionals, autonomy-driven motivation, diabetes self-perceived competence and self-esteem in adults (age 18–55 yrs) with suboptimally regulated type 1 diabetes mellitus (T1DM) with at least one HbA1c≥8.0% (≥64 mmol/mol) during the past year, and whether these factors could predict decrease in self-esteem over time.MethodsA cross-sectional population-based survey was performed, and 9 months follow-up data were collected. Data collection comprised clinical and socio-demographic variables, blood sampling (HbA1c) and self-report questionnaires; the Health Care Climate Questionnaire (HCCQ), Treatment Self-Regulation Questionnaire (TSRQ), the Perceived Competence in Diabetes Scale (PCDS), and the Rosenberg Self-esteem Scale (RSES). We fitted block-wise linear regression models to assess associations between RSES and variables of interest (HCCQ, TSRQ, PCDS, HbA1c, clinical and socio-demographic variables) and linear regression models to assess predictors of change over time.FindingsIn this study sample, aged 36.7 (±10.7) mean HbA1c 9.3% (±1.1), 31.5% had long-term complications and 42.7% had experienced severe hypoglycemia within the previous 12 months. In the final regression model the association between PCDS and RSES was strongly significant (B = 1.99, p<0.001) and the associations between HCCQ, TSRQ and RSES were reduced to non-significance. All predictor variables combined explained 42% of the variability of RSES (adjusted R2 = 0.423) with PCDS contributing 18% to explained variance (R-square change = 0.184, p<0.001). The strongest predictors of change in RSES over time were long-term complications (B = 2.76, p<0.001), specifically foot-related problems, and being female (B = -2.16, p = 0.002).ConclusionsPerceived autonomy support, autonomy-driven motivation and diabetes self-perceived competence play a significant role in explaining self-esteem among adults with suboptimally regulated T1DM. Healthcare professionals should acknowledge self-esteem as a valuable factor in understanding the multifaceted health choices people with T1DM make.Trial registrationClinical Trials.gov with identification number NCT 01317459.