Title- Cross-sectional, analytical survey of diabetic foot care -An urban rural
The incidence of diabetes is
increasing and spreading rapidly in the world. Diabetes is known as “silent
killer, complex and potentially chronic illness” due to the body’s inability to
properly regulate blood glucose and insulin levels, this chronic illness can
cause complications in many areas of the body mainly the lower extremities and
remains the “leading cause of nontraumatic lower-limb amputation. (1)
One of the most
distressing complication that affects diabetic patient is diabetic foot disease.
It is caused by vascular and neurological pathologic changes that direct result
of diabetes, causing local tissue destruction by sensory neuropathy and
compromise of the vascular system of affected lower extremities. (2) The
morbidity, impairment of quality of life and the involved lots of money for treatment
management have impact on family, society and health system. (3) The major
medical problems faced by the diabetic patient, approximately 20% of hospital
admissions are related to the foot complications and lack of knowledge
regarding footcare so the people at high risk. (4)
complications like ulcers, infections and gangrene and risk of loss of limb or
life. Foot ulceration and infection are leading risk factor of amputation and
Diabetes is a major
health care problem in India. According to Atlas published by the International
Diabetes Federation (IDF) (5) there were an estimated 40 million persons with
diabetes in India 2007 and the number predicted to rise to almost 70 million
people by 2025. The countries with largest number of diabetic people will be in
India, china by 2030. (6)
Awareness of good foot
care in mainly type 2 diabetes mellitus patients and health care providers to
reduce the incidence of foot disease. A psychologically as well as behaviorally
demanding diabetes greatly impacts one’s daily routine life. As part of a
comprehensive approach to diabetes management, daily foot self-care can contribute
to an overall reduction of health risks and complications from the disease.
Therefore, one’s daily self-care is a key factor
in prevention of lower extremity amputations in those with diabetic foot. Awareness
involves the ability to know and understand those factors that will further
develop beliefs and manner of attitude towards this disease and daily practices
Aims and Objectives-
The purposes of this study
were to assess the level of foot self-care performed in a rural and in urban
area and to identify factors associated with foot self-care and to educate the
people who with diabetes who are at low risk of complications.
1. To assess the knowledge, attitude and practice regarding foot care in type 2
DM patients in urban and rural hospital setting
2. To do comparative analysis of knowledge, attitude, practice of type 2 DM
patient of rural hospital with urban hospital
3. To provide health education to people on diabetic foot care, based on our
Material and method-
Type of Study- Cross Sectional,
Sampling method- Convenient Sampling
Study Population- Patients who are
already diagnosed with Diabetes Mellitus Type 2 & are presented in OPD /IPD
of a rural hospital & urban
Study Period- 2 months
Inclusion Criteria- Patient diagnosed as
DM-2 in OPD/IPD of Tertiary Care hospital & rural hospital. Data will be collected
by using the structured questionnaire and check list for assessing knowledge
and practice regarding diabetic foot care.
Statistical Tool- The data organized and
analyzed by using descriptive and inferential statistics with the help of SPSS
Data Collection Procedure- The proforma
will be used to assess the knowledge & practice of previously diagnosed
diabetic patients who are attending OPD or admitted in IPD, regarding foot care
at a tertiary care hospital & a rural hospital using a structured
questionnaire. The patients will be asked objective questions by interviewer.
The self- administered questionnaire
tool was designed for the study consists of 3 sections.
It consists of 16
items relating to demographic data of the subjects such as Age, Gender,
Department, Education, Religion, Marital Status, Type of family, Occupational
Status, Monthly Income, Residence, Habits and Personal History Including Any
Associated Illness, Family History of Diabetes, Duration of Diabetes, Source of
Information of Diabetes and Admitted with History of Foot Ulcer.
It consists of 10
items relating to knowledge regarding foot care in diabetes such as hygiene and
It consists of
checklists of 10 items relating to practices regarding foot care.
Ethical Consideration- The project is
submitted for ethical consideration at Institutional Ethical Committee.
Written, informed consent will be taken from participants.
8.Type of Family-
12.Associated Medical Conditions-
13.Duration of DM-2
14. Family History of DM-
15.Source of Information on DM-
16. Admitted with the history of Foot
Section –B (Knowledge & Attitude
about Diabetic Foot Care)
1. DM patients may develop lack of
sensation in their feet. —–Yes/No
2. DM patients may develop foot ulcers/ gangrene.
3. Are you aware that smoking can reduce
blood flow in your feet?
4. Do you know that with loss of
sensation in your foot, you are more prone to foot ulcers?
5. Are u aware of role of foot ware in
preventing foot ulcers?
6. DM patients should take
responsibility for self-foot examination.
7. Diet is important in the control of
8. Have you ever received education
about foot care from the doctor?
9. Have you ever read any hand-outs on
foot care/foot wear?
1. Can you reach your feet?
2. Do you examine your feet?
3. Do you wash your feet every day?
4. DO you dry between your toes?
5. Do you use cream?
6. Do you use cream between your toes?
7. Do you use medicated foot products?
8. Do you file your toe nails?
9. Do you trim your toe nails?
10. Do you walk barefoot?
11. Do you inspect your shoes prior to
12. Do you soak your feet?
13. If Yes above, do you check the water
temperature before soaking your feet?
14. Do you use a hot-water bottle on
15. Do you smoke?
Based on our findings It
is expected that how many people have proper knowledge of foot care hygiene? In
that majority of patients had poor knowledge and practice of foot care. The
costs of diabetes foot care along with medications are high and rising which
affect themselves physically, mentally and psychologically along with their
families. Improve the quality of healthcare center can be implemented in public
sector settings with minimum use of resources and money to reduce the foot
disease. As per study there are lots of difference in rural and urban diabetic
patient’s knowledge regarding foot care hygiene.
Wendling, V. Beadle / The relationship between self-efficacy and diabetic foot
self-care /Journal of Clinical & Translational Endocrinology 2 (2015) 37-41.
2. Goie TT, Naidoo M. Awareness of diabetic
foot disease amongst patients with type 2 diabetes mellitus attending the
chronic outpatient department at a regional hospital in Durban, South Africa.
Afr J Prm Health Care Fam Med. 2016;8(1), a1170. http://dx.doi.
org/10.4102/ phcfm. v8i1.1170
3 &4. D. G. Mote and S. D. Mote/ Diabetic foot infections and management: A
Rural Indian Perspective/ International Journal of Biomedical Research 2015;
5&6 Manisha C. Gholap, Vaishali R. Mohite/
To Assess the Knowledge & Practice
Regarding Foot Care among Diabetes patients at KRISHNA HOSPITAL, KARAD/ Indian
J.Sci.Res. 4(2): 69-75, 201