Diabetic foot care knowledge and practice in type 2 diabetes and relation to microvascular complications in Alexandria (Egypt)

Educate African Americans with type 2 diabetes (T2DM) on the importance of daily foot self-care to prevent the development of diabetic foot ulcers (DFU): a quality improvement project

INTRODUCTION

Diabetic foot ulcers (DFUs) are a preventable healthcare pandemic. DFUs, a preventable diabetic complication, account for 6% of the diabetic population. Therefore, it is very necessary to address this growing health crisis through educational awareness to attenuate this preventable illness. Lack of education on the importance of routine basic foot care is one of the major casualties of the development of DFU, which, if not addressed, expeditiously leads to preventable lower limb amputation (LLA). Researchers have shown that approximately 0.03%-1.5% of diabetic patients need LLA, a costly and preventable complication. Hence, lack of education on the importance of safe routine foot care, such as lack of basic diabetic foot self-care awareness, walking without proper foot protection, delayed foot care and inappropriate care can negatively augment the pathological changes and lead to severe complications such as DFU, LLA and foot deformity. Researchers have indicated that educating diabetic patients on the importance of safe daily foot self-care will help prevent the development or exacerbation of DFUs. Foot care education for diabetic patients is one of the single most important methods of preventing DFUs. Clinical intervention, in this case, educating African Americans (AAs) on the importance of daily foot self-care in clinical practice will help decrease and prevent the development of DFUs among AAs with type 2 diabetes.

RESULT

Pretest-posttest shows significant knowledge gain. Of the total volunteers screened, 20% had previous ulcers that healed successfully; however, they were not being followed up by a foot specialist. None of the screened volunteers had current or active foot ulcers. 60% of volunteers had diabetic neuropathy determined via monofilament test; these abnormalities were not previously detected. Many volunteers had more than one positive item; therefore, they met the requirement for referral to a diabetic foot specialist.

Enhancing foot care education and support strategies in adults with type 2 diabetes

BACKGROUND

People with diabetes are susceptible to serious and disabling foot complications, which increase their morbidity and mortality rates. Examining the perspectives of people with diabetes on their foot care routines could help elucidate their beliefs and offer practical ways to prevent foot problems.

PURPOSE

We explored the perspectives of adults with diabetes on their foot care practices to identify and enhance foot care education and support strategies.

METHODOLOGY

Using the Zoom platform, 29 adults with diabetes completed a 3-month telehealth educational program, during which interviews were conducted. This article reports the results of thematic content analysis of the qualitative data. Coded participant statements were organized into categories and reexamined to identify emergent themes.

RESULTS

Analysis of participants' perceptions revealed four main themes of influences that facilitated and/or hindered their foot care practices. Foot care behaviors were facilitated by patients' personal knowledge of others with diabetes-related foot consequences (theme 1). Foot care practices were hindered by the emotional impact of living with diabetes (theme 2), and the physical, social, and lifestyle limitations associated with foot care (theme 3). Finally, patients noted that interactions with family could be either a facilitator or hindrance to their foot care routines (theme 4).

CONCLUSIONS

These findings highlight multiple patient-centered factors related to personal, physical, psychosocial, and cultural influences that affect foot care behaviors.

IMPLICATIONS

An understanding of how patients manage diabetes-related foot care can help nurse practitioners enhance foot care education and support strategies in this population.

Foot Care Prioritization Among Health Care Providers Treating Diabetic Patients in Saudi Arabia: A Survey-Based Study

BACKGROUND

Diabetic foot disease (DFD) is a significant complication associated with diabetes, characterized by the potential for progressive amputation of specific foot segments or the entire lower limb in the absence of timely identification of infection and intervention. The aim of our research is to evaluate the degree of importance given to foot care by healthcare professionals who are responsible for treating individuals with diabetes in Riyadh, Saudi Arabia.

METHODS

This cross-sectional study utilized an online survey previously validated in Australia. The mean foot care prioritization score was used to identify the dummy variable for binary logistic regression analysis, which was used to identify predictors of foot care prioritization.

RESULTS

A total of 222 participants were involved in this study. Assessing for the risk of developing foot complications, visually inspecting feet for wounds, and providing or recommending footwear to prevent foot complications were the most commonly reported practices, accounting for 80.60% (n = 178), 76.10% (n = 169), and 75.20% (n = 167), respectively. The most commonly referred patients to a specialist tertiary multi-disciplinary foot care team were patients with ulcers in patients with absent foot pulses, ulcers with ascending cellulitis, and diabetic ulceration, accounting for 73.50% (n = 163), 71.60% (n = 159), and 66.70% (n = 148), respectively. The mean foot care prioritization score for the study participants was 54.1 (standard deviation: 11.7) out of 78 (69.4%), which demonstrates a moderately high level of foot care prioritization. Binary logistic regression analysis identified that healthcare professionals who are aged 35-44 years, those who have 5-10 years of experience, those who work at private hospitals, those who have a higher number of practice clinics per week, and those who have to manage a higher number of patients with diabetes in each clinic were more likely to prioritize foot care in their practices (p < 0.05).

CONCLUSION

Our study found that healthcare professionals in Saudi Arabia place a moderate degree of emphasis on foot care. Healthcare professionals falling within the age range of 35-44 years, possessing 5-10 years of experience, employed at private hospitals, overseeing a greater number of practice clinics weekly, and managing a greater number of patients with diabetes per clinic exhibited a greater propensity to prioritize foot care within their respective practices. Policymakers should consider the integration of continuous glucose monitoring technologies, the establishment of standardized foot screening protocols, and the implementation of targeted educational programs for healthcare professionals.