Diabetic Foot Care Education and Practices: A Knowledge, Attitudes, and Practices Questionnaire-Based Study

Abstract

Background Diabetic foot disease is a significant cause of morbidity among individuals with diabetes and can be effectively prevented with proper patient education early in the disease course. This study was conducted with the aim of assessing the knowledge, attitudes, and practices of diabetic patients toward foot care, as well as estimating the prevalence of diabetic foot disease. Methods A cross-sectional study was conducted among 128 diagnosed patients with diabetes, using a structured questionnaire and the Michigan Neuropathy Screening Instrument (MNSI) parts A and B, at a referral hospital in Central India. The questionnaire included questions about foot care practices, knowledge of diabetic foot complications, and attitudes toward foot care. The MNSI was used to screen for neuropathic symptoms and signs indicative of diabetic foot disease. Results Among the participants, 110 out of 128 (85.9%) reported that they had never received any education from their healthcare provider regarding proper foot care practices. Almost one-fourth of our participants, accounting for 95 (74.2%) of them, lacked adequate knowledge about maintaining proper foot hygiene, and 78 (60.9%) were unaware of the foot-related complications associated with diabetes. The study found a significant positive association between knowledge scores and the duration of diabetes. Despite the lack of knowledge, 125 (97%) of the patients demonstrated a positive attitude and expressed a willingness to adopt proper practices when educated. Notably, 52 (40.6%) of the participants walked barefoot, and 116 (90.6%) did not undergo annual foot examinations. Diabetic foot disease was identified in 40 out of 128 (31.3%) participants based on abnormal MNSI scores. There was a significant positive correlation between the duration of diabetes and the presence of diabetic foot disease. Higher MNSI score A was associated with poorly controlled diabetes, highlighting the impact of glycemic control on neuropathic symptoms. The presence of diabetic foot disease was also significantly associated with macroalbuminuria. Conclusion Our study revealed substantial deficiencies in the education of diabetic patients concerning foot care practices. The prevalent positive attitude among the patients indicates that diabetic foot disease can be effectively prevented with adequate patient education and proactive care by primary healthcare providers. Addressing these deficiencies in awareness and practice is essential for improving patient outcomes and preventing severe complications associated with diabetic foot disease.

Keywords: diabetic foot disease; diabetic foot ulcer; kap for diabetic foot; michigan neuropath screening instrument; peripheral neuropathy.

Figure 1. Scatter plot showing correlation between MNSI A and MNSI B, correlation coefficient 0.47 (P < 0.01)

MNSI - Michigan Neuropathy Screening Instrument

Figure 2. Michigan Neuropathy Screening Instrument Part A

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Figure 3. Michigan Neuropathy Screening Instrument Part B

Downloaded from [11]