Foot Self-care in Diabetes Mellitus: Evaluation of Patient Awareness

SLR - January 2020 - Tyler W. Claveau

Reference: Yılmaz Karadağ F, Saltoğlu N, Ak Ö, Çınar Aydın G, Şenbayrak S, Erol S, Mıstanoğlu Özatağ D, Kadanalı A, Küçükardalı Y, Çomoğlu Ş, Yörük G, Akkoyunlu Y, Meriç Koç M, Altunçekiç Yıldırım A. Foot Self-care in Diabetes Mellitus: Evaluation of Patient Awareness. Prim Care Diabetes. 2019 Jul 12

Scientific Literature Review

Reviewed By: Tyler W. Claveau, DPM
Residency Program: Beaumont Wayne Hospital, Wayne, MI

Podiatric Relevance: Diabetes Mellitus is one of the most common metabolic disorders in the world and frequently these are patients of the podiatric surgeon. Diabetic patients may often present with complications including neuropathy, leading to ulcers and infection. Because of this, good self-foot care of the patient is imperative to the prevention of complications. The objectives of the current study were to assess patients’ knowledge and practices regarding foot self-care among diabetic patients in Turkey.

Methods: A total of 1,030 diabetic patients were enrolled in Turkey from November 2017 to February 2018. Inclusion criteria included: 18 years or older, referral for any reason to the internal medicine polyclinic or diabetic foot polyclinic, or infectious disease clinic, and having a diagnosis of Diabetes Mellitus. Patients were asked to take a 10-question survey evaluating  knowledge in regards to diabetic foot care and their practices. Questions included things such as: daily foot washing, drying, daily foot examinations, nail care, and footwear choices. Each correct choice was counted as one point with a total of 10 points. Patients were then divided into three groups: zero to four points meaning bad foot care, five to seven points meaning moderate foot care, and eight to 10 points meaning good foot care.

Results: The results of the survey showed that 29.5 percent of patients had bad foot care (zero to four points), 49.6 percent of patients had moderate foot care (five to seven points) and 20.8 percent of patients had good foot care (eight to ten points). Patients’ sociodemographic characteristics were evaluated with regard to foot-care results. It was found that patients with good foot care knowledge had higher education and were more likely to live in a city, have higher income, and were more likely to have type I Diabetes Mellitus. Additionally, disease duration was longer in those who had good foot care compared to the other groups. Also, patients who had received training about foot self-care had significantly higher scores than those who did not receive training. On the other hand, there no significant differences between the groups in terms of age, sex, history of foot infection and having undergone amputation. A total of 228 (21.14 percent) patients had received foot self-care training.

Conclusions: In conclusion, the study found that diabetic patients from Turkey generally have poor foot care behavior. They found that knowledge, income, education status and disease duration significantly influenced patients’ practice of foot care. This study shows the importance of increasing awareness of diabetic patients about proper foot care practice in order to reduce the incidence of complications. It’s important for podiatric surgeons to take an active role in educating our patients about the importance of self-foot care. Many complications secondary to Diabetes Mellitus can be avoided with proper diabetic pedal examinations and decrease morbidity and mortality.