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This study assessed the knowledge and practice of diabetic patients towards diabetic foot care and their general understanding of diabetes causes, complications, and treatment. Methods: A cross-sectional study was conducted at Aldaraga Clinic Centre, Sudan, with a sample size of 100 diabetic patients. A questionnaire and checklist were used to collect data for this study. The data was analyzed through SPSS Version 16 software. Results: The majority of respondents were females (62%), above 40 years old (66%), married, with a low educational level, and moderate-income (76%). The study revealed that most respondents did not attend any educational program about diabetes, indicating poor or no knowledge about diabetes mellitus. However, respondents had good knowledge of most signs and symptoms of diabetes, with the highest percentage (88%) for extreme thirst. Concerning the knowledge of respondents about complications of diabetes, it was generally poor, except for retinal diseases (70%). Participants' knowledge of signs and symptoms of hypoglycemia was found to be poor at 25%. The study showed that most respondents did not know what diabetes gangrene is. Foot infections were the most dominant cause of hospitalization among diabetic patients, often leading to amputations. Conclusion: Enhancing foot care behaviours in diabetic patients is crucial to reduce diabetic foot ulceration risks. Patient-friendly educational interventions and regular physician reinforcement are urgently needed, including awareness programs, specialized diabetes centres, and health education through mass media to improve foot care practices and prevent complications like amputations. [ABSTRACT FROM AUTHOR]

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Diabetes mellitus reportedly affects 5.6% of the Scottish population, a number that is increasing by -0.1% annually. In Scotland, 4.7% of people with diabetes will experience foot ulceration in their lives, with 0.5% undergoing lower-limb amputation (Scottish Diabetes Data Group, [SDDG] 2018). It is estimated that care costs for people with diabetes account for £1 billion of the £13 billion total spend of NHS Scotland (Colhoun and McKnight, 2020). The main causes of diabetic foot disease leading to amputation are peripheral arterial disease (PAD) in combination with damage to small nerves and blood vessels secondary to hyperglycaemia (Weledji and Fokam, 2014). Many healthcare professionals are involved in the management of PAD and chronic limb-threatening ischaemia, and variability in practice patterns and access to services is high, which contributes to a disparity in assessment, treatments and clinical outcomes. The aim of the study was to assess whether the use of the WIFI classification system is feasible in busy, specialised podiatry wound care clinical settings. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the overall differences in the standard of preventive foot care for patients at risk of diabetic foot ulceration and to identify specific demographic factors affecting these health care practices, including race and ethnicity. The National Health and Nutrition Examination Survey data for 2011 to 2018 were analyzed. Participants (20 years and older) with diabetes were categorized as White, Black, Hispanic, Asian, and others (including multiracial participants) based on self-reported race and ethnicity. The primary outcome was foot examination over the past year administered by a medical professional. Logistic regression was performed to examine the effects of race and ethnicity on the annual diabetic foot examination, controlling for age (65 years and older), gender, and health insurance status. Among the 2,836 participants included in the study (weighted percentage: 61.1% were White, 13.9% were Black, 15.1% were Hispanic, 5.4% were Asian, and 4.5% were other), 2,018 (weighted percentage: 71.6%) received annual diabetic foot examination over the past year. Hispanic participants (adjusted odds ratio [aOR] = 0.685; 95% CI, 0.52–0.90) were significantly less likely than White participants to receive an annual foot examination (Black participants: aOR = 1.11; 95% CI, 0.83–1.49; Asian participants: aOR = 0.80; 95% CI, 0.60–1.07; other participants: aOR = 0.66; 95% CI, 0.40–1.10). Factors associated with receipt of foot examination were age 65 years or older (aOR = 1.42; 95% CI, 1.05–1.92) and having health insurance (aOR = 3.02; 95% CI, 2.27–4.03). Our findings suggest that Hispanic adults with diabetes are receiving disproportionately lower rates of preventive foot care compared with their White counterparts. This significant variation in the standard of care for individuals with diabetes reflects the need to further identify factors driving the disparities in preventive foot care services among racial and ethnic minority groups. [ABSTRACT FROM AUTHOR]

Objectives. Egypt occupies the 8th rank in the prevalence of diabetes mellitus worldwide. The social and financial burden of diabetes and its complications represents a major health problem in Egypt. Diabetic foot and its consequences (ulcers and amputation) are preventable through good education for both physicians and patients.

Objective: In this study, the content of Turkish YouTube videos as a source of information on diabetic foot care training and the presence of nurses in these videos were examined.Methods: A search was performed in the video sharing platform YouTube with the keyword "diabetic foot care" on 09.12.2020. From 200 videos, 87 were included in the study, and they were independently evaluated by two investigators for their usefulness, reliability, and quality.Results: Of the videos, 8% were categorized as very useful, 33.3% moderately useful, 51.7% somewhat useful, and 6.9% not useful, while 4.6% contained misleading information. It was also found that the instructor was a nurse in only 12.6% of these videos.Conclusion: There is useful information about diabetic foot care on YouTube; however, there are also videos with misleading information. In addition, it has been observed that very few of these videos were prepared by nurses. In order to improve the foot care behaviors of individuals with diabetes, it may be suggested that professional groups, especially nurses who are primarily responsible for training and care, should create original, detailed, and interesting videos on appropriate diabetic foot care. [ABSTRACT FROM AUTHOR]

Diabetes is a pervasive and lifelong condition and poses significant challenges, with one of its most debilitating complications being foot diseases, particularly foot ulceration. This condition not only places individuals at risk for infection but also represents a precursor to severe consequences, such as sepsis and lower-limb amputation (Lipsky et al, 2023). This article delves into the multidisciplinary role that is pivotal in mitigating lower-limb foot ulcer recurrence, a pervasive issue affecting a substantial portion of the diabetic population. [ABSTRACT FROM AUTHOR]

Diabetic foot ulcers (DFUs) are a common but serious complication of diabetes mellitus (DM). The factors distressing the worth of diabetic foot care (DFC) are knowledge and practice. Foot ulcers are the main cause of amputation and death in people suffering from DM. This study assessed the knowledge and practice of DFC and the prevalence of DFUs and its associated factors among diabetic patients of selected hospitals in the Volta Region, Ghana. A multihospital‐based cross‐sectional study was conducted among 473 patients with DM who were recruited using the systematic sampling method. Data were collected using a validated, pretested, and structured questionnaire, while medical variables were obtained from patient folders and analysed using SPSS version 23. All statistically significant parameters in bivariate analysis were incorporated in the multivariate logistic regression analysis. The results showed that 63% of diabetic patients had good knowledge of DFC, while 49% competently practiced it. A negative correlation was found between knowledge and practice levels of DFC (r = −0.15, P = <.01). The prevalence of DFUs was 8.7% among the studied diabetic patients. Male diabetic patients were 3.4 times more likely to develop DFUs than female diabetic patients (crude odd ratio [cOR] = 3.35; 95% confidence interval [CI] = 1.75‐6.43; P = <.001). Type 1 diabetic patients were five times more likely to develop DFUs than those who had type 2 diabetes (cOR = 5.00; 95% CI = 2.50‐10.00; P = <.001). Diabetic patients who had a family history of diabetes were 4.7 times more likely to develop DFUs than those without family history (adjusted odd ratio [aOR] = 4.66; 95% CI = 1.55‐13.89; P =.006). Those who had diabetes for 5 to 10 years were 3.3 times more likely to develop DFUs than those who had diabetes for less than 5 years (aOR = 3.28; 95% CI = 1.40‐7.67; P =.006). Diabetic patients who had comorbidity were 3.4 times more likely to develop DFUs than those without comorbidity (cOR = 3.35; 95% CI = 1.74‐6.45; P = <.001). The study found that there was good knowledge but poor practices of DFC among patients. Health care providers are expected to better educate patients and emphasise self‐care practices to patients. Health care providers should also give more attention to patients with associated risk factors to avoid further complications and reduce the occurrence of DFUs. [ABSTRACT FROM AUTHOR]

Nurses are required to make quantitative, evidence-based observations when implementing diabetic foot care. This study aimed to clarify the characteristics of lower-limb ischemia in patients with type 2 diabetes using subjective and objective symptoms and physiological indicators and whether the physiological characteristics are established as predictive indicators of arterial obstruction. Fifty Japanese patients with type 2 diabetes (100 limbs) were classified into three groups using the ankle–brachial index (ABI). Patients with an ABI of ≤0.69 had subjective and objective symptoms of blood flow disturbance, such as pain at rest, cold sensation, pale skin, and imperceptibility to the dorsalis pedis artery. Blood flow in the first toe was the lowest. Binary logistic regression analysis established hallux perfusion as a predictive model for lower-limb arterial occlusion (odds ratio = 0.979, 95% confidence interval 0.900–0.999). Thus, when nurses perform diabetic foot care, it is necessary to evaluate not only subjective and objective symptoms, but also blood flow at the microcirculatory level of the great toe.

Background: Evidence regarding the foot care practices among practitioners is still scarce in the Indian scenario. This study aimed at assessing the foot care practices among diabetologists from various parts of the country. Methods: A cross-sectional online survey was conducted among diabetologists, to understand their foot care practices across India, who were part of Diabetic Foot Research India (DFRI) and have participated in the study. Results: In a total of 89 participants, majority of the diabetologists examined patients with a history of foot infection once in 3 months (53%), 128 Hz tuning fork has been used for diagnosis of high-risk foot (31%), majority of patients were advised to use TCC by diabetologists (73%), and footwear was manufactured by qualified orthotist and prosthetics (60%). The foot problems commonly treated by diabetologists are cellulitis (26%) followed by callus (24%). Patients were also referred to other specialists (69%); almost all the participants used antibiotics (95%), and medication and wound care management (29%) were also a part of their practice. Conclusion: The diabetologists displayed a multidisciplinary approach to the treatment and management of foot care practices among patients with foot complications. It is imperative to establish effective communication between diabetologists and/or other practitioners to generate sufficient evidence to determine the foot care practices throughout the country. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) is a chronic non-infectious disease with complications such as diabetic foot, which has the potential for amputation if left untreated. Theory of Planned Behavior (TPB) is a behavior-based theory that can be applied to DM patients including foot care to minimize risk. Some studies related to TPB particularly about physical activity and diet have been explored, however, studies on foot care are still lacking. Objective: This study aims to apply the Theory of Planned Behavior (Intentions, Attitudes, Subjective Norms and Behavioral Control) on the patient's foot care. Methods: This was a cross sectional descriptive study. There were 93 patients diagnosed with type 2 DM recruited at 9 public health centers (Puskesmas) using accidental sampling on April 2018. TPB-based foot care questionnaire from the IWGDF (International Working Group on Diabetic Foot) Diabetic Foot guidelines was used. Data were analyzed in the form of frequency distribution. Results: Of the total number of respondents, 25 males and 68 females with average age of 53.05 ± 8.04 years, approximately 87.1% of them have the intention to wear footwear according to size. The majority of patients think that washing feet every day is a form of good and positive practice. They also agreed that the family expects the patient to examine the presence of bone / joint protrusions independently and believes that monitoring the foot deformities performed by other DM patients is very important as well as having control that the patient can check for signs of boils in the legs and there is a high likelihood of blisters / sores if the socks used are not suitable. Conclusion: The majority of respondents have good intentions, positive attitudes, social support and behavioral controls for foot care.

Aims and objectives: To examine the level of self‐care behaviours among patients with diabetic foot ulcers and identify factors related to their self‐care behaviours. Background: This study focused on the self‐care behaviours of patients diagnosed with diabetic foot ulcers, a complication of diabetes. Design: A cross‐sectional study design was adopted. Methods: From July–August 2018, 131 outpatients and inpatients with diabetic foot ulcers were given a survey questionnaire regarding self‐care behaviours and expected related factors at two Korean hospitals. In this study, self‐care behaviours were diabetes management and diabetic foot care. Demographic, disease‐related and laboratory characteristics were collected. The data were analysed in terms of descriptive statistics, a t test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. STROBE checklist was used as the guideline for this study. Results: Moderate levels of self‐care behaviours were found. The stepwise multiple regression analysis revealed that diabetes management was significantly related to perceived family support, experience of diabetic education, perceived stress, a problem‐focused coping style, experience of hospitalisation and comorbidity. Furthermore, diabetic foot care was significantly associated with the experience of diabetic education, perceived family support, and serum level of erythrocyte sedimentation rate and haemoglobin A1C. Conclusions: Perceived family support was the main factor affecting diabetes management, and diabetic foot care was greatly affected by the experience of diabetic education. It is necessary to develop diabetes education programmes and nursing interventions to increase family support to improve the self‐care behaviours of patients with diabetic foot ulcers. Relevance to clinical practice: Self‐care behaviours among patients with diabetic foot ulcers are important, as they affect healing of the wound and the quality of life. Further development of family‐based diabetes education or programmes is recommended to promote the self‐care behaviours of patients with diabetic foot ulcers. [ABSTRACT FROM AUTHOR]

Background: Diabetes is one of the major health problems worldwide that can be effectively managed by good self-care activities like medication adherence, exercise, monitoring of blood glucose, foot care and diet. Objectives: The study assessed the self-care activities of diabetic patients using summary of diabetes self-care activities scale (SDSCA) and the variables (Age, gender, educational level, socioeconomic status (SES)) associated with it. Methods: A cross-sectional descriptive study was undertaken in 400 Type 2 diabetic patients. Self-care practices of the patients were evaluated by using SDSCA and correlation with variables were determined statistically. Results: Among 400 diabetic patients about 215 (53.75%) had an average score of self-care. Self-care was poor in 184 (46%) subjects, and only 1 subject (0.25%) scored good. Blood sugar monitoring was the highest (100%) followed by medication adherence (92.75%) whereas inadequate levels of self-care were reported in foot care (1.5%), and physical activity (31.5%) domains. A significant positive correlation was found between self-care practices and socio-demographic variables such as age (r=0.298, p=0.000), income (r=0.490, p=0.000) occupation (r=0.433, p=0.000), education (r=0.582, p=0.000), and Socio-Economic status (r=0.599, p=0.000). Conclusion: The study revealed higher level of adherence to self-care activities in terms of blood sugar monitoring and medication taking behaviour in the current setting, but self -care in other domains such as foot care is critically low. Age, education and Socio-Economic status seems to affect the self-care practice by the patients. [ABSTRACT FROM AUTHOR]

Introduction: Diabetic Peripheral Neuropathy (DPN) causes damage to the peripheral nerves. Vibration Perception Threshold (VPT) helps to test the loss of protective sensation of the nerves. Aim: To find the association between VPT values and clinical symptoms of DPN. Materials and Methods: The descriptive study assessed association between the VPT values and clinical symptoms of 220 diabetic patients selected by purposive sampling. The VPT was measured by a sensitometer. A metal probe was placed under the toes of the patient and the voltage was increased gradually from zero and the transition from no vibration to the point of vibration is marked as VPT. Average of three measurements were taken to calculate the VPT value of the given patient. The VPT values were graded as ‘normal’ (25 as ‘severe’ neuropathy. Data were collected using S-LANSS pain score and questionnaire on clinical symptoms of DPN. Frequency and percentage were used to analyse the sample characteristics and Fishers exact to find the association between VPT values and the clinical symptoms. Pearson’s correlation was computed between the VPT value and number of neuropathic symptoms. Results: Almost all 219 (99.5%) the patients were symptomatic and a moderate positive correlation (r=+0.59) was found between VPT values and clinical symptoms of DPN. Sensory symptoms were observed in 96.5% of patients. Clinical symptoms of diabetic peripheral neuropathy such as unsteadiness, slipping of foot from chappal, tingling, callus, dry skin, cut/ulcer, hyper pigmentation, black discolouration, oedema, pin and needle sensation (plantar), muscle cramps, night symptoms, osteomyelitis were significantly associated with VPT value. There was a positive correlation between VPT values and the number of symptoms of DPN (r=0.590). Conclusion: Diabetic patients are at risk for DPN and proper foot care is mandatory to prevent foot complications and probable amputation. So, VPT score can be considered an indicator of DPN and be used to identify high-risk patients.

Good knowledge and practice regarding diabetic foot care will reduce the risk of diabetic foot complications and ultimately amputation. This study is conducted to assess patients’ knowledge and compliance of diabetic foot care. A cross sectional study performed on patients who were admitted to HSNZ from the 1st September 2013 to 30th April 2014 for diabetic foot infections. They were interviewed with a questionnaire of 15 ‘yes’ or ‘no’ questions on foot care knowledge and practice. Score of 1 was given for each ‘yes’ answer. The level of knowledge and practice, whether good or poor, was determined based on the median score of each category. The result was tested using a chi-square test in SPSS version 17. A total of 157 patients were included in this study with a mean age of 56.33 years (31-77). There were 72 male (45.9%) and 85 female (54.1%) patients with the majority of them being Malays (154 patients, 98.1%). Majority of the patients (58%) had poor foot care knowledge while 97 patients (61.8%) had poor diabetic foot care practice as compared to the median score. Based on the chi square test of relatedness, there was no significant association between knowledge and practice with any of the variables. In conclusion, the majority of patients admitted for diabetic foot infections had poor knowledge and practice of diabetic foot care. Education regarding foot care strategies should be emphasized and empowered within the diabetic population

Introduction: Diabetic Peripheral Neuropathy (DPN) causes damage to the peripheral nerves. Vibration Perception Threshold (VPT) helps to test the loss of protective sensation of the nerves. Aim: To find the association between VPT values and clinical symptoms of DPN. Materials and Methods: The descriptive study assessed association between the VPT values and clinical symptoms of 220 diabetic patients selected by purposive sampling. The VPT was measured by a sensitometer. A metal probe was placed under the toes of the patient and the voltage was increased gradually from zero and the transition from no vibration to the point of vibration is marked as VPT. Average of three measurements were taken to calculate the VPT value of the given patient. The VPT values were graded as 'normal' (<15v), 'mild' (15-20v), 'moderate' (20-25v) and >25 as 'severe' neuropathy. Data were collected using S-LANSS pain score and questionnaire on clinical symptoms of DPN. Frequency and percentage were used to analyse the sample characteristics and Fishers exact to find the association between VPT values and the clinical symptoms. Pearson's correlation was computed between the VPT value and number of neuropathic symptoms. Results: Almost all 219 (99.5%) the patients were symptomatic and a moderate positive correlation (r=+0.59) was found between VPT values and clinical symptoms of DPN. Sensory symptoms were observed in 96.5% of patients. Clinical symptoms of diabetic peripheral neuropathy such as unsteadiness, slipping of foot from chappal, tingling, callus, dry skin, cut/ulcer, hyper pigmentation, black discolouration, oedema, pin and needle sensation (plantar), muscle cramps, night symptoms, osteomyelitis were significantly associated with VPT value. There was a positive correlation between VPT values and the number of symptoms of DPN (r=0.590). Conclusion: Diabetic patients are at risk for DPN and proper foot care is mandatory to prevent foot complications and probable amputation. So, VPT score can be considered an indicator of DPN and be used to identify high-risk patients. [ABSTRACT FROM AUTHOR]

Background: diabetic foot ulcer is a major health problem around the world with a high morbidity and mortality rates. The good knowledge and practice pattern could decrease the diabetic foot ulcer complications. Objectives: this study aimed to evaluate knowledge of the diabetic patients regarding the complications of diabetic foot ulcer in Saudi Arabia (KSA). Patients and Methods: this is a cross sectional community based study conducted from March 2017 to July 2017 among 920 diabetic patients. The subjects were interviewed in the shopping malls, pharmacies and coffee shops and asked to fill out a pre-tested questionnaire about the knowledge of complications. Results: the duration of diabetes was more than 10 years among 65% of them. About 40.9% of subjects were using oral hypoglycemic agents, 57.8% were using insulin for management of diabetes. The most common diabetic complication was retinopathy, while the most common foot ulcer complication was foot numbness and stiffness. The level of knowledge was good among most of subjects (77%), while 23% had insufficient knowledge regarding the diabetic foot ulcer. The good awareness was significantly associated with higher educational levels. Conclusion: the level of awareness about complications of diabetic foot was sufficient among most of Saudi subjects. But, there was an urgent need for raising the awareness and identifying the risk factors, educating the patients through increasing the patients and doctors relationship. The knowledge alone was not sufficient for assessing the practice pattern thus major studies must be conducted to assess the knowledge, attitude and practice pattern among Saudi subjects. [ABSTRACT FROM AUTHOR]

Background and Aim: Diabetes mellitus (DM) is one of the most common public health problems worldwide. Diabetic foot as a late complication of DM imposes high physical and emotional costs to the patients. The purpose of this study was to determine the effect of an educational program based on the Health Belief Model (HBM) on diabetic foot care in type-2 DM patients. Materials and Methods: Ninety seven (female=57, male=40) type-2 diabetes patients, randomly divided into two groups ̶ and intervention (n = 47) and a control group (n = 50) ̶ participated in this study. Using questionnaires data were collected, initially and 3 months after the educational intervention, on demographic characteristics, awareness and the HBM constructs. The intervention group participated in 3 educational sessions during the3-month period. The data were analyzed by SPSS 20, the statistical test being Shapiro-Wilk, Chi-Square, Wilcoxon, McNemar tests and paired T-Test. Results: There were no statistically significant differences before the intervention between the experimental and control groups with respect to the mean scores of knowledge and HBM's components (perceived susceptibility, severity, benefits and barriers, as well as self-efficacy and self-care). The intervention improved the scores significantly in the experimental groups (p<0.05), while there were no significant changes in the control group scores (p>0.05). Conclusion: This study shows that type-2 diabetic patients need to learn how to take care of their feet and that implementing educational programs based on the Health Belief Model can be effective in this regard. [ABSTRACT FROM AUTHOR]

Background: Diabetic foot significantly affects the quality of life of patients with diabetes. It leads to loss of labor force, psychosocial trauma, and high treatment costs due to serious morbidity and mortality. Nurses have an important responsibility to improve the metabolic status of individuals with diabetes, to protect them from foot complications, and to teach patients foot care skills., Aim: This study investigated the effects of education on type 2 diabetes patients regarding diabetic foot care and self-efficacy., Materials and Methods: This quasi-experimental study was conducted from February to July 2016 in hospitals located in the city of Balıkesir in Turkey with type 2 diabetes patients who were admitted to the internal medicine clinic and monitored by the endocrinology and internal medicine outpatient clinics. G*power 3.1.9.2 software was used to calculate the sample size of 94 people with a 5% type 1 error, and 90% power. The study was carried out with stratified randomization, and a questionnaire was administered to the experimental and control groups. The experimental group received training, and both groups' scores on the Diabetic Foot Behavior Questionnaire [Appendix 1] and the Diabetic Foot Care Self-Efficacy Scale [Appendix 2] were compared after three months. The t-test, the paired t-test, and the Chi-square test were used., Results: While the self-efficacy and the foot care behavior scores of the control group did not show any differences (P > 0.05), the experimental group's scores were significantly higher (P < 0.05). The control group's self-efficacy and foot care behavior scores on the pre-test and final test were similar, while the experimental group's scores increased (P < 0.05)., Conclusions: Starting from the diagnosis of diabetes, it is advisable to carry out foot assessments and to follow up with diabetics who received foot care education to increase their self-efficacy, to make foot care a habit, and to re-evaluate missing or incorrect practices during check-ups., Competing Interests: None