1
|
Karthiksaravanan K, Meriton AS. A study on prevalence of diabetic peripheral neuropathy in diabetic patients attending a rural health and training centre. J Family Med Prim Care 2024; 13:726-729. [PMID: 38605777 PMCID: PMC11006058 DOI: 10.4103/jfmpc.jfmpc_709_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/22/2023] [Accepted: 10/03/2023] [Indexed: 04/13/2024] Open
Abstract
Introduction Diabetic neuropathy is a common complication, affecting up to half the diabetics. Diabetic peripheral neuropathy (DPN) predominantly affects the hands and lower limbs. It leads to loss of protective sensation, resulting in continuous injury to insensitive feet. The early detection of DPN using an objective screening test followed by its appropriate management is important, as up to 50% of diabetic peripheral neuropathies may be asymptomatic. Objectives To screen diabetic patients attending a Rural Health and Training Centre of a medical college in Tamil Nadu for DPN. To assess the association between DPN and sociodemographic factors, duration of diabetes, glycemic control, physical activity, body mass index, smoking and habit of alcohol consumption. Materials and Methods The study was conducted among 206 diabetic patients attending a Rural Health and Training Centre. Participants were assessed using the Michigan Neuropathy Screening Instrument (MNSI), which involves using a questionnaire followed by a physical examination. Results Of the 206 patients, 61.2% were male, and 38.8% were female. The mean age was 50.86 years (standard deviation [SD] = 12.26 years). The mean duration of diabetes was 8.3 years (SD = 5.5 years). The proportion of diabetics who were screened positive for peripheral neuropathy was 16.5% and 21.8% using the MNSI questionnaire and examination, respectively. Age of 60 years and above was significantly associated with DPN.(OR = 3.982, P value = 0.0001). Duration of more than 5 years of diabetes was also significantly associated with DPN.(OR = 6.01, P value = 0.003). Conclusion A high proportion of diabetics were screened positive for peripheral neuropathy, and many of them were unaware of having the complication. Many risk factors associated with DPN were reported in this study. Thus, early diagnosis and management with MNSI or any other validated screening tool in health care institutions is essential.
Collapse
Affiliation(s)
- K. Karthiksaravanan
- Department of Community Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - A. S. Meriton
- Department of Community Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| |
Collapse
|
2
|
Alkalash SH, Alnashri FH, Alnashri AI, Alghubayshi KA, Alsumaydi MA, Alzubaidi WS, Alshuqayfi SM, Alkudaysi FM, Qusty NF. Knowledge, Attitude, and Practice of Adult Diabetics Regarding Diabetic Foot Ulcers: A Cross-Sectional Study in Saudi Arabia. Cureus 2024; 16:e53356. [PMID: 38435926 PMCID: PMC10908437 DOI: 10.7759/cureus.53356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2024] [Indexed: 03/05/2024] Open
Abstract
Background Diabetic foot ulcers (DFUs) are one of the most common and fatal complications of diabetic patients with uncontrolled diabetes mellitus (DM) that may end with their feet amputation. These complications can be prevented through the adherence of diabetic patients to their diabetes management plan and by educating them about risk factors, complications of diabetic foot, and proper foot care. To develop effective health education programs to educate diabetic patients and caregivers regarding diabetic foot and its effective care, we should first identify gaps in patients' knowledge and perception of diabetic foot and evaluate their practice of foot care. Objectives This study aimed to evaluate knowledge and attitude toward DFUs and the practice of foot care among adult diabetic patients attending Al-Qunfudah Diabetes Center, Saudi Arabia, from October 2022 to March 2023. Methods A total of 403 adult diabetic patients were recruited in this cross-sectional study during their attendance at the diabetes center in Al-Qunfudah district, Saudi Arabia. The study researchers conducted a physical face-to-face interview with each diabetic patient using a validated questionnaire with closed-ended questions to collect their responses regarding their knowledge and attitude toward DFUs and their behavior toward foot care. The collected data were analyzed using IBM SPSS Statistics for Windows, version 23 (released 2015; IBM Corp., Armonk, New York, United States). Results Out of 403 diabetics, 50.4% (n = 203) had inadequate knowledge (knowledge score < 80%), 46.4% (n = 187) had negative attitudes (attitude score < 80%) toward DFUs, and the majority could not practice foot care well, with 77.7% (n = 313) giving a practice score less than 80%. Seventy patients (17.4%) self-reported a history of DFUs. Predictors of good knowledge about DFUs among diabetics include age between 30 and 59 years (odds ratio (OR) = 2.942, confidence interval (CI) 95% = 1.695-2.107, p < 0.001), marriage (OR = 3.101, CI 95% = 1.893-5.079, p < 0.001), working (OR = 5.325, CI 95% = 3.019-9.389, p < 0.001), diploma education (OR = 8.205, CI 95% = 3.332-20.203, p < 0.001), managing DM with oral drugs (OR = 2.219, CI 95% = 1.399-3.519, p < 0.001), and having no DFUs (OR = 2.712, CI 95% = 1.557-4.723, p < 0.001). Males were more likely to practice foot care well (OR = 1.925, CI 95% = 1.142-3.245, p = 0.013). Primary education (OR = 3.421, CI 95% = 1.655-7.073, p < 0.001) predicted appropriate foot care. Patients with DM for one to five years (OR = 1.995, CI 95% = 1.139-3.493, p = 0.016) and those on diet and metformin (OR = 2.133, CI 95% = 1.134-4.011, p = 0.019) were expected to have better foot care than other diabetics. Conclusion Diabetic patients in the Al-Qunfudah district of Saudi Arabia had inadequate knowledge and negative attitudes toward DFUs, and their foot care behaviors were inadequate. Furthermore, DFUs were self-reported in around 17% of diabetic patients. Specialized training programs are recommended to enhance knowledge regarding DFUs among diabetics and motivate and train them and caregivers on how to conduct proper foot care. These educational programs should target all diabetics, with an emphasis on those with DFUs, females, non-working patients, individuals who have had DM for a longer time, and illiterate diabetics. To understand the factors behind patients' negative attitudes toward diabetic foot, future qualitative research is required.
Collapse
Affiliation(s)
- Safa H Alkalash
- Community Medicine and Health Care, Umm Al-Qura University, Al-Qunfudah, SAU
- Family Medicine, Menoufia University, Shibin El Kom, EGY
| | | | | | | | | | | | | | - Fuad M Alkudaysi
- Pediatric Department, South Al-Qunfudah Hospital, Al-Qunfudah, SAU
| | - Naeem F Qusty
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, SAU
| |
Collapse
|
3
|
Elafros MA, Callaghan BC, Skolarus LE, Vileikyte L, Lawrenson JG, Feldman EL. Patient and health care provider knowledge of diabetes and diabetic microvascular complications: a comprehensive literature review. Rev Endocr Metab Disord 2023; 24:221-239. [PMID: 36322296 PMCID: PMC10202021 DOI: 10.1007/s11154-022-09754-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2022] [Indexed: 11/05/2022]
Abstract
Diabetic retinopathy, neuropathy, and nephropathy occur in more than 50% of people with diabetes, contributing substantially to morbidity and mortality. Patient understanding of these microvascular complications is essential to ensure early recognition and treatment of these sequalae as well as associated symptoms, yet little is known about patient knowledge of microvascular sequalae. In this comprehensive literature review, we provide an overview of existing knowledge regarding patient knowledge of diabetes, retinopathy, neuropathy, and nephropathy. We also discuss health care provider's knowledge of these sequalae given that patients and providers must work together to achieve optimal care. We evaluated 281 articles on patient and provider knowledge of diabetic retinopathy, neuropathy, and nephropathy as well as predictors of improved knowledge and screening practices. Results demonstrated that patient and provider knowledge of microvascular sequalae varied widely between studies, which may reflect sociocultural or methodologic differences. Knowledge assessment instruments varied between studies with limited validation data and few studies controlled for confounding. Generally, improved patient knowledge was associated with greater formal education, longer diabetes duration, and higher socioeconomic status. Fewer studies examined provider knowledge of sequalae, yet these studies identified multiple misconceptions regarding appropriate screening practices for microvascular complications and the need to screen patients who are asymptomatic. Further investigations are needed that use well validated measures, control for confounding, and include diverse populations. Such studies will allow identification of patients and providers who would benefit from interventions to improve knowledge of microvascular complications and, ultimately, improve patient outcomes.
Collapse
Affiliation(s)
| | | | - Lesli E Skolarus
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Loretta Vileikyte
- Division of Diabetes, Endocrinology, and Gastroenterology, University of Manchester, Manchester, UK
- Department of Endocrinology and Dermatology, University of Miami, Miami, FL, USA
| | - John G Lawrenson
- School of Health and Psychological Sciences, City, University of London, London, UK
| | - Eva L Feldman
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
- Department of Neurology, Michigan Medicine, University of Michigan, 48109, Ann Arbor, MI, USA.
| |
Collapse
|
4
|
Gong D, Han Y, Zhang Q, Xu B, Zhang C, Li K, Tan L. Development of Leather Fiber/Polyurethane Composite with Antibacterial, Wet Management, and Temperature-Adaptive Flexibility for Foot Care. ACS Biomater Sci Eng 2022; 8:4557-4565. [DOI: 10.1021/acsbiomaterials.2c00748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Dakai Gong
- College of Biomass Science and Engineering, Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu 610065, China
| | - Yanting Han
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu 610065, China
| | - Qiang Zhang
- College of Biomass Science and Engineering, Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu 610065, China
| | - Bo Xu
- College of Biomass Science and Engineering, Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu 610065, China
| | - Chunxiao Zhang
- College of Biomass Science and Engineering, Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu 610065, China
| | - Ka Li
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu 610065, China
| | - Lin Tan
- College of Biomass Science and Engineering, Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu 610065, China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China
| |
Collapse
|
5
|
Kumar Gupta S, Rastogi A, Kaur M, Malhotra S, Lakshmi PVM. Foot Self-Care Behaviour among People with Type 2 Diabetes mellitus Living in Rural Underserved Area of North India: A Community-Based Cross-Sectional Study. INT J LOW EXTR WOUND 2022:15347346221110074. [PMID: 35758288 DOI: 10.1177/15347346221110074] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of this study was to ascertain the foot self-care behaviour and its associated factors among people with type 2 diabetes mellitus (T2DM) living in the rural resource-constrained health setting of Punjab, North India. A community based cross sectional study was undertaken in the randomly selected underserved rural area of District Fatehgarh Sahib, Punjab, North India. A pre-validated Nottingham Assessment of Functional Footcare (NAFF) scale was administered to assess foot self-care behaviour, and participants were classified based on the percentage of a maximum possible score of 84 on the scale, as poor, if the score was <50%, satisfactory if score 50%-70% and >70% good foot self-care behaviour. A total of 700 participants' responses were recorded. The study results revealed that 84% (588) of the respondents had poor, 16% (112) had satisfactory, and none were following good foot self-care behaviour. An outcome of multivariable logistics regression suggested satisfactory foot self-care behaviour was significantly associated with foot self-care education, with an adjusted odds ratio (aOR) of 2.83 (95%, CI:1.62 - 4.93; p <0.01) among respondents who had received foot self-care education, literate than illiterate (aOR 2.50 95%, CI:1.31- 4.74; p <0.01) and women compared to men (aOR 1.69 95%, CI: 1.06 -2.70; p -0.26). This study revealed that foot self-care behaviours were alarmingly low among people with T2DM living in rural resource-constrained health settings of Punjab, North India, suggesting an urgent need to disseminate foot self-care education to prevent diabetes foot related complications.
Collapse
Affiliation(s)
- Saurabh Kumar Gupta
- Department of Community Medicine and School of Public Health, 29751Post Graduate Institute of Medical Education and Research, Chandigarh, 160012
| | - Ashu Rastogi
- Department of Endocrinology, 29751Post Graduate Institute of Medical Education and Research, Chandigarh, 160012
| | - Manmeet Kaur
- Department of Community Medicine and School of Public Health, 29751Post Graduate Institute of Medical Education and Research, Chandigarh, 160012
| | - Sunita Malhotra
- Department of Dietetics, 29751Post Graduate Institute of Medical Education and Research, Chandigarh, 160012
| | - P V M Lakshmi
- Department of Community Medicine and School of Public Health, 29751Post Graduate Institute of Medical Education and Research, Chandigarh, 160012
| |
Collapse
|
6
|
Health Education Programmes to Improve Foot Self-Care Knowledge and Behaviour among Older People with End-Stage Kidney Disease (ESKD) Receiving Haemodialysis (A Systematic Review). Healthcare (Basel) 2022; 10:healthcare10061143. [PMID: 35742194 PMCID: PMC9222212 DOI: 10.3390/healthcare10061143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 11/17/2022] Open
Abstract
Background: ESKD is a total or near-permanent failure in renal function. It is irreversible, progressive and ultimately fatal without peritoneal dialysis (PD), haemodialysis (HD) or kidney transplantation. Dialysis treatments can create new and additional problems for patients, one of which is foot amputation, as a result of non-healing wounds and vascular complications. The association between dialysis therapy and foot ulceration is linked to several factors: physical and psychological health; peripheral arterial disease (PAD); mobility; tissue oxygenation; manual dexterity; neuropathy; visual acuity; anaemia; nutrition; leg oedema; hypoalbuminemia; infection; inadequacy of dialysis; and leg/foot support during dialysis. The potential risk factors for foot ulceration may include: not routinely receiving foot care education; incorrect use of footwear; diabetes duration; neuropathy; and peripheral arterial disease. Aim: The aim of this review is to examine the factors that help or hinder successful implementation of foot care education programmes for ESKD patients receiving haemodialysis. Method: A comprehensive literature search was completed using five electronic databases. Medline; CINAHL; Embase; PsycINFO; and Cochrane Library. The Joanna Briggs Institute checklist (JBI) was used to quality appraise full text papers included in the review. The systematic review was not limited to specific categories of interventions to enable optimal comparison between interventions and provide a comprehensive overview of the evidence in this important field of foot care. Results: We found no previously published studies that considered foot care education programmes for haemodialysis patients who are not diabetic; thus, the present systematic review examined four studies on diabetic patients receiving haemodialysis exposed to foot care education programmes from various types of intervention designs. Conclusions: This systematic review has provided evidence that it is possible to influence foot care knowledge and self-care behaviours in both diabetic patients receiving haemodialysis and healthcare professionals.
Collapse
|
7
|
Diabetic foot care knowledge and practice in type 2 diabetes and relation to microvascular complications in Alexandria (Egypt). Endocr Regul 2022; 56:95-103. [PMID: 35489046 DOI: 10.2478/enr-2022-0011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
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. Methods. This cross-sectional study was conducted on 100 patients with type 2 diabetes attending diabetes outpatient clinic in Alexandria main university hospital (AMUH). Patients were subjected to history taking, physical examination, and laboratory investigations. Screening for peripheral neuropathy was done using Michigan Neuropathy Screening Instrument (MNSI). A pre-tested questionnaire was used to assess the diabetic foot care knowledge and practice in participants. Results. Only 25% and 24% of participants had good diabetic foot care knowledge and practice, respectively. There was a highly significant positive correlation between knowledge and practice in studied group (p<0.001). The presence of microvascular complications leads to a significantly higher knowledge, but not practice. Conclusions. Diabetic foot care knowledge and practice are poor in our community. Foot care knowledge, unlike practice, is increased with the presence of microvascular complications. We should develop effective educational programs for patients and physicians to increase knowledge and practice before the development of complications.
Collapse
|
8
|
Olowo S, Iramiot JS, Ssenyonga LV. Knowledge of diabetic foot complication, self-care beliefs and practices among patients attending a tertiary hospital in Eastern Uganda. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
9
|
Kamalarathnam S, Varadarajan S. Diabetic peripheral neuropathy in diabetic patients attending an urban health and training centre. J Family Med Prim Care 2022; 11:113-117. [PMID: 35309653 PMCID: PMC8930172 DOI: 10.4103/jfmpc.jfmpc_470_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/05/2021] [Accepted: 07/19/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction: Diabetic neuropathy is a complication affecting almost 50% of the diabetic patients. Diabetic Peripheral Neuropathy (DPN) predominantly affects the hands and lower limbs. It leads to loss of protective sensation resulting in continuous injury to insensitive feet. The early detection of DPN using an objective screening test followed by its appropriate management is important as up to 50% of the patients may be asymptomatic. Objectives: To screen Diabetic patients attending an Urban Health and Training Centre of a medical college in Tamilnadu for Diabetic Peripheral Neuropathy. To assess the association between DPN and selected variables such as socio-demographic factors, glycaemic control, duration of diabetes, physical activity, body mass index, smoking and consumption of alcohol. Methods: The study was conducted among 204 diabetic patients attending an Urban Health and Training Centre. Participants were assessed using Michigan Neuropathy Screening Instrument (MNSI), which involves using a questionnaire followed by a physical examination. Results: Of the 204 patients, 58.8% were male. The mean age was 54.8 years (SD = 8.8 years). About 79.9% were employed of which 29.4% were skilled labourers. Mean duration of diabetes was 6.2 years (SD = 5.3 years). The proportion of diabetics who screened positive for Peripheral Neuropathy was 23% and 45.6% using MNSI questionnaire and examination, respectively. An age of 60 years and above was significantly associated with DPN (OR = 2.505, P value = 0.003). A duration of more than 4 years of diabetes was also significantly associated with DPN (OR = 1.872, P value = 0.02820). Conclusion: A high proportion of diabetics with peripheral neuropathy did not express symptoms specific for diabetics. Thus, a simple tool like MNSI would be useful in primary care settings to screen for peripheral neuropathy, and hence prevent disability”.
Collapse
|
10
|
Wazqar AA, Baatya MM, Lodhi FS, Khan AA. Assessment of knowledge and foot self-care practices among diabetes mellitus patients in a tertiary care centre in Makkah, Saudi Arabia: a cross-sectional analytical study. Pan Afr Med J 2021; 40:123. [PMID: 36118942 PMCID: PMC9463747 DOI: 10.11604/pamj.2021.40.123.30113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/10/2021] [Indexed: 11/07/2022] Open
Abstract
Introduction diabetic foot is a common long-term complication of uncontrolled diabetes mellitus. Knowledge about foot self-care practices among diabetic patients in Saudi Arabia is limited. Thus, the aim of this study was to assess the level of patients´ knowledge and practices regarding self-care of diabetic foot among diabetic patients. Methods a cross-sectional analytical study was conducted using a sample of diabetic patients attending outpatient clinics at Heraa Diabetic Center, Ministry of Health, Makkah City, Saudi Arabia from June 2020 to July 2020. The participants were interviewed through a self-administered questionnaire inquiring sociodemographic factors, patients´ knowledge and practices regarding foot self-care. Results a total of 409 patients were included in this study. Respondents' ages ranged between 6 and 75 years with a mean of 42.5 years and standard deviation of 13.9 years. Females represented 51.1% of the participants. Type 2 diabetes represented 85.6% of the responses. Overall, most of the participants (72.4%) had a poor level of knowledge whereas only 4.2% expressed a good level of knowledge. Being employed (P = 0.046), type II diabetes patients (P = 0.047) and those whose main source of information was health staff (P = 0.026) were more knowledgeable compared to their peers. Almost two-thirds (63.3%) of patients showed a poor level of practice related to diabetic foot self-care. Conclusion low level of knowledge and practice of foot care are prevalent among diabetic patients attending outpatient clinics at Heraa Diabetic Center. Designed interventions should be implemented to enhance diabetic foot self-care.
Collapse
Affiliation(s)
- Abrar Ali Wazqar
- Ministry of Health, Makkah, Saudi Arabia,,Corresponding author: Abrar Ali Wazqar, Ministry of Health, Makkah, Saudi Arabia.
| | | | - Fahad Saqib Lodhi
- Saudi Board of Preventive Medicine, Ministry of Health, Makkah, Saudi Arabia
| | - Adeel Ahmed Khan
- Saudi Board of Preventive Medicine, Ministry of Health, Makkah, Saudi Arabia
| |
Collapse
|
11
|
Gupta SK, Lakshmi PVM, Rastogi A, Kaur M. Development and evaluation of self-care intervention to improve self-care practices among people living with type 2 diabetes mellitus: a mixed-methods study protocol. BMJ Open 2021; 11:e046825. [PMID: 34210727 PMCID: PMC8252870 DOI: 10.1136/bmjopen-2020-046825] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/02/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION The management of diabetes mellitus (DM) depends on medication adherence, self-care and regular follow-up to prevent complications and premature mortality. This study aims to develop and implement the behavioural change theory and model based diabetes self-care intervention package to improve self-care practices among people living with type 2 DM. METHODS AND ANALYSIS An exploratory sequential mixed-method study design wherein, quantitative follows qualitative will be used to develop, implement and evaluate the effect of diabetes self-care intervention package among people living with type 2 diabetes. The qualitative research method will be used to identify barriers and facilitators for self-care practices among people living with type 2 DM and will also provide the basis for the development of the diabetes self-care intervention package. The quasi-experimental with control study design will be used to evaluate the developed intervention package among 220 randomly selected people living with type 2 diabetes in both intervention and control arms. Baseline, follow-ups and endline data will be collected using same prevalidated and structured questionnaire for each self-care activity. Difference-in-difference analysis will be used to measure for changes in the proportion of people living with type 2 DM doing different component of self-care practices, preintervention and postintervention in both arms. ETHICS AND DISSEMINATION Permission for conducting the study has been taken from Institutional Ethical Committee of PGIMER, Chandigarh (Ref no. NK/4538/PhD/226, Dated 18.08.18). The findings of the trial will be disseminated through publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER CTRI/2018/10/016108; Pre-results.
Collapse
Affiliation(s)
- Saurabh Kumar Gupta
- Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, Chandigarh, India
| | - P V M Lakshmi
- Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, Chandigarh, India
| | - Ashu Rastogi
- Department of Endocrinology, PGIMER, Chandigarh, Chandigarh, India
| | - Manmeet Kaur
- Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, Chandigarh, India
| |
Collapse
|
12
|
Tuglo LS, Nyande FK, Agordoh PD, Nartey EB, Pan Z, Logosu L, Dei-Hlorlewu AE, Haligah DK, Osafo L, Taful S, Chu M. Knowledge and practice of diabetic foot care and the prevalence of diabetic foot ulcers among diabetic patients of selected hospitals in the Volta Region, Ghana. Int Wound J 2021; 19:601-614. [PMID: 34190402 PMCID: PMC8874051 DOI: 10.1111/iwj.13656] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/16/2021] [Indexed: 11/26/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Lawrence Sena Tuglo
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, China
| | - Felix Kwasi Nyande
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Percival Delali Agordoh
- Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Eunice Berko Nartey
- Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Zhongqin Pan
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, China
| | - Lydia Logosu
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Atsu Eyram Dei-Hlorlewu
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Desire Koku Haligah
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Linda Osafo
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Simon Taful
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Minjie Chu
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, China
| |
Collapse
|
13
|
Alsaleh FM, AlBassam KS, Alsairafi ZK, Naser AY. Knowledge and practice of foot self-care among patients with diabetes attending primary healthcare centres in Kuwait: A cross-sectional study. Saudi Pharm J 2021; 29:506-515. [PMID: 34194257 PMCID: PMC8233518 DOI: 10.1016/j.jsps.2021.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/12/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Diabetes mellitus is a major public health issue and is the main cause of morbidity and mortality worldwide. At the time of diagnosis, many patients with type 2 diabetes (T2D) have one or two risk factors for diabetic foot diseases, such as diabetic peripheral neuropathy (DPN) and diabetic foot ulcers (DFUs). Patients can overcome such complications through good knowledge and practice of foot self-care. This study aims to evaluate the knowledge and practice of foot care among patients with diabetes mellitus attending primary healthcare centres (PHCs) in Kuwait and to identify those at risk for developing DPN. METHODS A cross-sectional study was conducted using a pre-tested self-administered questionnaire. The questionnaire included questions on demographic characteristics and patients' knowledge and practices of foot care. Adult patients (aged 21 and above) with a diagnosis of diabetes mellitus for at least 1 year were randomly selected from PHCs located in the five governorates of Kuwait. Data were analysed using SPSS, version 26. RESULTS A total of 357 patients participated in this study, giving a response rate of 87.3%. The overall mean knowledge score of foot care was 12.7 ± 2.7 (equals 81.3%). Most patients (n = 283, 79.3%) showed good knowledge. In comparison, less than one-third of patients (n = 110, 30.8%) practiced good foot care. The overall mean score of patients' practices was 55.7 ± 9.2 (equals 64.0%). Approximately 17.4% of the patients had a higher risk of developing DPN. University students had lower odds of having good knowledge about foot care [OR: 0.19 (95%CI: 0.04-0.86)]. On the other hand, patients who reported having diabetes for a long duration (10 years and above) [OR: 1.88 (95%CI: 1.11-3.18)] and patients who did not have any other comorbidities [OR: 0.49 (95%CI: 0.26-0.90)] had higher odds of having good foot care knowledge. Patients who were on oral hypoglycaemic agents (OHAs) only had lower odds [OR: 0.63 (95%CI: 0.39-1.00)] of practicing good foot care. Patients who reported having diabetes for a duration between 5 to less than 10 years [OR: 1.75 (95%CI: 1.06-2.90)] and those who are on a diet only [OR: 1.76 (95%CI: 1.06-2.94)] had higher odds of practicing good foot care. Patients who were using combination therapy with OHAs and insulin had a higher risk [OR: 2.67 (95%CI: 1.11-6.41)] of developing DPN. On the other hand, patients who reported that they did not have a previous history of foot ulcer had a lower risk of developing DPN [OR: 0.21 (95%CI: 0.09-0.47)]. CONCLUSION The knowledge of patients with diabetes regarding foot care is rated as good, while their self-practice is considered satisfactory. To improve the foot care knowledge and self-care practice of patients, healthcare providers (HCPs) need to support patients through educational programmes and appropriate training.
Collapse
Affiliation(s)
- Fatemah M. Alsaleh
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait
| | - Khaled S. AlBassam
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait
| | - Zahra K. Alsairafi
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait
| | - Abdallah Y. Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| |
Collapse
|
14
|
Manickum P, Mashamba-Thompson T, Naidoo R, Ramklass S, Madiba T. Knowledge and practice of diabetic foot care - A scoping review. Diabetes Metab Syndr 2021; 15:783-793. [PMID: 33838615 DOI: 10.1016/j.dsx.2021.03.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/07/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS This review aims to systematically map global evidence on foot-care knowledge and practices in relation to diabetes mellitus (DM) and identify areas that need further research. METHODS Database searches were undertaken using Google Scholar, Medline (PubMed), Academic Search Complete (EBSCOhost), and Medline (EBSCOhost). Studies were initially sought by title and focused on knowledge of diabetic foot ulcer burden. The framework by Arksey and O'Malley and the PRISMA-SCR guidelines were used to guide the methodology. The themes explored were principles of foot-care knowledge and practice and these were reported using content analysis. The mixed-methods appraisal tool (MMAT) was employed to appraise the quality of the primary studies. RESULTS Fifty-eight studies published between 2008 and 2018 met the inclusion criteria. Participants in various studies had varying degrees of foot-care knowledge and practice, including foot inspection, foot hygiene, glycaemic control, and foot protection. Many people had knowledge of the various aspects of foot care but fewer practiced proper foot care. The MMAT showed the majority of the articles to be of high quality. CONCLUSIONS Level of foot-care knowledge and practice varied in the studies. A need for intervention on foot care was highlighted.
Collapse
Affiliation(s)
- Prabashni Manickum
- School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
| | | | - Rasmika Naidoo
- Department of Occupational Therapy, Addington Hospital, KwaZulu-Natal, South Africa
| | - Serela Ramklass
- School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Thandinkosi Madiba
- Gastrointestinal Cancer Research Group, Department of General Surgery, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
15
|
Application of protection motivation theory to diabetic foot care Behaviours in Egypt. J Diabetes Metab Disord 2020; 19:869-873. [PMID: 33520808 DOI: 10.1007/s40200-020-00573-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Foot care behaviours are considered the first line of defense against diabetic foot complications. In general, preventive behaviours are determined by multiple personal, social and psychological factors. The aim of this study was to assess foot care behaviours and their relation to protection motivation theory among a sample of adults with diabetes in Egypt. METHODS A self-administered questionnaire was used to collect data about foot care practices and protection motivation theory among a random sample of 300 adults with diabetes attending primary health care units in Egypt. RESULTS The results demonstrated that the foot care behaviours were inadequate amongst the sample(mean 5.13 ± 1.92 out of 11). Three constructs of protection motivation theory predicted the behaviours, namely: self-efficacy (p = 0.015), perceived seriousness (p = 0.013) and intention to adhere to foot care (p = 0.021). On the other hand, intention to adhere to foot care was correlated with higher levels of self-efficacy and perceived seriousness, and to lower levels of perceived barriers. CONCLUSION There was a low level of foot self-care amongst the sample. Health education programs reinforcing the intention to adhere to foot care behaviours can improve foot care practices among people with diabetes through increasing self-efficacy and perceived seriousness and reducing perceived barriers.
Collapse
|
16
|
Prevalence of peripheral neuropathy among type 2 diabetes mellitus patients in a rural health centre in South India. Int J Diabetes Dev Ctries 2020. [DOI: 10.1007/s13410-020-00885-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
17
|
Pavithra H, Akshaya KM, Nirgude AS, Balakrishna AG. Factors associated with awareness and practice about foot care among patients admitted with diabetes mellitus: A cross sectional research from a medical college hospital of southern India. Nepal J Epidemiol 2020; 10:897-904. [PMID: 33042593 PMCID: PMC7538014 DOI: 10.3126/nje.v10i3.29213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 09/20/2020] [Accepted: 09/28/2020] [Indexed: 11/18/2022] Open
Abstract
Background Diabetes Mellitus (DM) causes micro and macro vascular complications. One of the complications of DM is diabetic foot that results in amputations and decreased quality of life. The aim of this study was to assess the awareness and practice about foot care and associated factors among admitted patients in a teaching hospital of coastal Karnataka, India. Material and Methods A cross-sectional study was conducted in a medical college hospital after obtaining institutional ethics approval from 24th December 2016 to 21st January 2017. Adults with diabetes (N=317) admitted in the hospital were interviewed with a validated structured questionnaire for awareness and practice regarding foot care. The scores obtained were further graded into good and poor. Data was analyzed with SPSS version 22 for descriptive statistics. Bivariate logistic and linear regressions were used to determine the association between variables and awareness/practice scores. Results Mean age of the participants was 56.98 (±10.54) years with males constituting the majority (63.4%). Good awareness and practice scores were observed among 69.1% and 41.6% participants, respectively. Good awareness scores were associated with male patients (p=0.027), currently not married (p=0.044), below poverty line socioeconomic status (p=0.014) and presence of foot ulcer (p=0.021). Good practice scores was associated with secondary schooling (p=0.003) and receiving insulin (p=0.045). Moderate correlation with coefficient 0.493 (p<0.001) was observed between awareness and practice scores. Conclusion Seven and four out of 10 study participants had good awareness and practice scores about foot care, respectively. A tailor-made health education module addressing the lacunae identified in the awareness and practice domains needs to be provided to the patients with diabetes mellitus.
Collapse
Affiliation(s)
- H Pavithra
- Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, Karnataka, India, 575018
| | - Kibballi Madhukeshwar Akshaya
- Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, Karnataka, India, 575018
| | - Abhay Subashrao Nirgude
- Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, Karnataka, India, 575018
| | - A G Balakrishna
- Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, Karnataka, India, 575018
| |
Collapse
|
18
|
Foot care practices among Diabetologists in India: A descriptive study by the Diabetic Foot Research India. Int J Diabetes Dev Ctries 2020. [DOI: 10.1007/s13410-020-00847-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
19
|
Hanley G, Chiou PY, Liu CY, Chen HM, Pfeiffer S. Foot care knowledge, attitudes and practices among patients with diabetic foot and amputation in St. Kitts and Nevis. Int Wound J 2020; 17:1142-1152. [PMID: 32744425 DOI: 10.1111/iwj.13446] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/09/2020] [Accepted: 06/16/2020] [Indexed: 11/27/2022] Open
Abstract
About one-third of admissions to the surgical unit annually are diabetes foot infections in need of amputation In St. Kitts and Nevis. However, the risk factors related to diabetes foot and amputation remain unknown. This study investigated factors associated with diabetic foot and amputation (DFA). Retrospective case control study design, and purposive and quota sampling method was used to recruit the participants. Patients with and without DFA were interviewed at two main hospitals, several primary health centres, and a private doctor's office during July and August 2018. Self-development questionnaires were applied to assess patients' demographic, physical and behaviour, foot care knowledge, attitudes, and practices related to DFA. Chi-square, t-test, and multiple logistic regressions were used to analyse the data. A total of 210 patients were evaluated, 89 had DFA, while 121 did not, with a mean age of 61.10 (SD = 11.85). Participants' responses indicated good knowledge, favourable attitudes, and adequate practices related to foot care. The two items of the questionnaire, ways to maintain blood flow in the lower extremities and wash their feet daily, had significant lower score in DFA group. In multiple logistic regression, knowledge, attitudes, and practices related to foot care were not a significant predictor of DFA. Being male was a predictor of DFA than female (OR = 3.53; 95% CI = 1.65-7.57; P < .01). Participants who were currently unemployed were less likely to have DFA than those who were employed (OR = 0.38; 95% Cl = 0.17-0.86; P < .05). Comparing patients with the longest experience of diabetes mellitus (31 years or more) with those who had diabetes for the shortest period of time (between 1 and 10 years) was less likely to have DFA (OR = 0.38; 95% CI = 0.15-0.97; P = <.05). The combination of these independent variables could explain 29% of the variance in DFA. Based on these findings, strategies to prevent diabetic foot and amputation should focus on male and outdoor heavy worker, and longer duration of diabetes patients which are identified in this study.
Collapse
Affiliation(s)
- Gracelyn Hanley
- Department of Nursing, Alexandra Hospital, Charlestown, Saint Kitts and Nevis
| | - Piao-Yi Chiou
- School of Nursing, College of Medicine, National Taiwan University, Taipei City, Taiwan.,Department of Nursing, National Taiwan University Hospital, Taipei City, Taiwan
| | - Chieh-Yu Liu
- Department of Speech Language Pathology and Audiology, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Hui-Mei Chen
- College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Stefani Pfeiffer
- International and Cross-strait Education Center, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| |
Collapse
|
20
|
Association between Knowledge of Sexually Transmitted Infections and Sources of the Previous Point of Care among Nigerians: Findings from Three National HIV and AIDS Reproductive Health Surveys. Int J Reprod Med 2020; 2020:6481479. [PMID: 31976315 PMCID: PMC6961610 DOI: 10.1155/2020/6481479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 07/31/2019] [Indexed: 11/18/2022] Open
Abstract
Background. Adequate knowledge of sexually transmitted infections (STIs) is critical for effective control of disease. Health education/counselling at the point of care provides ample opportunities to improve knowledge of patient seeking treatment. There is no study from Nigeria that investigates association between sources of previous point of care of STI and quality of knowledge of people on STI. We hypothesised that previous treatment of STI will be associated with better knowledge of STI and HIV infection. Methods. Three consecutives nationally representative cross-sectional surveys on HIV and AIDS Reproductive Health in Nigeria, conducted in 2005, 2007, and 2012 were analysed. Outcome measures were knowledge of STI only, and a combined knowledge of STI and HIV transmission and prevention. We designed a knowledge scale of 14-item questions for STI and 41-item questions for STI and HIV. Logistic regression was used to identify risk factors at 5% significance level. Results. Knowledge of STI increased from 13.4% in 2005 to 15.0% in 2007 to 26.5% in 2012. Respondents that received treatment from pharmacy and patient medicine vendors had higher odds of good knowledge of STI than those who did not receive any treatment (aOR = 2.55) in 2005. In 2012, respondents treated at health facilities were over two times likely to have good knowledge of STI and HIV transmission and prevention (aOR = 2.35). STI positive individuals in the highest economic class were two times likely to have good knowledge of STI and HIV transmission and prevention than those in the lowest class. Conclusion. Participants that previously sought care from health facilities, pharmacy, and patient medicine vendors had better knowledge of STIs and HIV infection prevention and transmission than those who sought care from unorthodox sources. We recommend a national awareness creation on STI prevention including provision of information on safe point of care for STIs in Nigeria.
Collapse
|
21
|
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; 13:515-520. [PMID: 31307915 DOI: 10.1016/j.pcd.2019.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 06/20/2019] [Accepted: 06/23/2019] [Indexed: 11/23/2022]
Abstract
AIMS To assess diabetic patients' knowledge and practices regarding foot care. METHODS This study was conducted as a cross-sectional study in 1030 patients between November 2017 and February 2018.The descriptive survey instrument was developed by the investigators. Survey content and format were based on prior surveys and guidelines. The survey sought socio-demographic characteristics of the patients and the level of knowledge about diabetic foot care practice. RESULTS 29.5% of patients had bad foot care, 49.6% of patients had moderate foot care and 20.8% of patients had good foot care. There were no significant differences between patient groups in regard to age, gender, foot infection history and having undergone amputation surgery. We found that patients who good at foot care had higher education status (p<0.001), were more likely live in a city (p<0.001), had higher income (p<0.001), had been trained about foot care (p<0.001) and were more likely to have type I DM (p=0.015). Disease duration was longer in those who had good foot care compared to the other groups (p=0.010). CONCLUSIONS The mean knowledge and practice scores of our patients were moderate, indicating that much is to be done for the education of patients on this matter. We also found that knowledge about the importance of this practice, education status and disease duration had significant influence on the practice of foot-care in patients with DM.
Collapse
Affiliation(s)
- Fatma Yılmaz Karadağ
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey.
| | - Neşe Saltoğlu
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey
| | - Öznur Ak
- Department of Infectious Diseases and Clinical Microbiology, Health Sciences University Kartal Dr. Lütfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Güle Çınar Aydın
- Department of Infectious Diseases and Clinical Microbiology, Ankara University School of Medicine, Ankara, Turkey
| | - Seniha Şenbayrak
- Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Serpil Erol
- Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Duru Mıstanoğlu Özatağ
- Department of Clinical Microbiology and Infectious Diseases, Dumlupınar University Faculty of Medicine,Kütahya, Turkey
| | - Ayten Kadanalı
- Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Yaşar Küçükardalı
- Department of Internal Medicine, Faculty of Medicine, Yeditepe University, Istanbul, Turkey
| | - Şenol Çomoğlu
- Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Gülşen Yörük
- Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Yasemin Akkoyunlu
- Department of Infectious Diseasesand Clinical Microbiology, Faculty of Medicine, BezmialemVakif University, Istanbul, Turkey
| | - Meliha Meriç Koç
- Department of Infectious Diseasesand Clinical Microbiology, Faculty of Medicine, BezmialemVakif University, Istanbul, Turkey
| | - Arzu Altunçekiç Yıldırım
- Department of Infectious Diseasesand Clinical Microbiology, Ordu University School of Medicine, Ordu, Turkey
| |
Collapse
|
22
|
Basu S, Sharma N. Diabetes self-care in primary health facilities in India - challenges and the way forward. World J Diabetes 2019; 10:341-349. [PMID: 31231457 PMCID: PMC6571487 DOI: 10.4239/wjd.v10.i6.341] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/10/2019] [Accepted: 05/14/2019] [Indexed: 02/05/2023] Open
Abstract
India has approximately 73 million people living with diabetes and another 37 million with prediabetes while nearly 47% of the diabetes cases are undiagnosed. The high burden of poor glycemic control and early onset of complications with associated economic costs indicates a high prevalence of poor self-management practices. It is well-established that achieving patient-centered primary care consistent with a chronic care model ensures optimum diabetes self-management support and improves long-term clinical and health outcomes in diabetes patients. The public sector primary care system in India provides services free of cost to beneficiaries but lacks patient-centered care that undermines diabetes self-management education and support. Furthermore, factors like poor patient knowledge of diabetes, suboptimal medication adherence, persistent clinical inertia, lack of data for monitoring and evaluation through clinical audit worsens the standards of diabetes care in primary care settings of India. There is a need for government initiatives to be directed towards the provision of comprehensive outpatient care that is inclusive of uninterrupted supply of drugs, provision of essential laboratory investigators, training and availability of qualified diabetes educators and availability of specialist support when required. Furthermore, the integration of depression screening and smoking cessation services at the primary care level is warranted.
Collapse
Affiliation(s)
- Saurav Basu
- Department of Community Medicine, Maulana Azad Medical College, New Delhi 110002, India
| | - Nandini Sharma
- Department of Community Medicine, Maulana Azad Medical College, New Delhi 110002, India
| |
Collapse
|
23
|
Alshammari ZJ, Alsaid LA, Parameaswari PJ, Alzahrani AA. Attitude and knowledge about foot care among diabetic patients in Riyadh, Saudi Arabia. J Family Med Prim Care 2019; 8:2089-2094. [PMID: 31334185 PMCID: PMC6618215 DOI: 10.4103/jfmpc.jfmpc_248_19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 03/25/2019] [Accepted: 04/10/2019] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Saudi Arabia ranks second as the highest country with the highest prevalence of diabetes mellitus (DM) in the Middle East and seventh in the world. Knowledge, attitude, and good practice for foot care are essential in the management and prevention of diabetic foot ulcers. OBJECTIVE This study was conducted to determine the knowledge, attitude, and practice to diabetic foot care among patients attending a diabetic clinic in Riyadh, Saudi Arabia. MATERIALS AND METHODS We conducted a descriptive cross-sectional study of all the patients with Type 1 and Type 2 diabetes aged ≥15 years seen at a diabetic clinic of King Saud Medical City in Riyadh, Saudi Arabia. A structured questionnaire on knowledge, attitude, and practices was used to collect the data. RESULTS In total, 368 diabetic patients were surveyed, comprising 111 (30.2%) males and 257 (69.8%) females. About 282 (76.6%) patients had good knowledge of diabetic foot and foot ulcers. Only 41 (11.1) patients have attended a class on diabetic foot care, and 81 (22.0%) received education on diabetic foot care from a doctor and 38 (10.3%) from a nurse. Majority of them washed their feet daily (98.4%), 59.8% inspects shoes before wearing them, but less than half of the patients (47.6%) actually self-inspect their foot daily. Being married, having a secondary and university level of education, and being a government employee had significantly better knowledge of diabetic foot compared with their counterparts. There were no significant differences in the attitude toward diabetic foot and diabetic foot care across age groups. Patients with longer duration of diabetes (>5 years) significantly had better practice of diabetic foot care. CONCLUSION This study revealed a high percentage of the surveyed population with good knowledge and good practice of diabetic foot care, however with a poor attitude toward foot care. There were very few patients who received formal education on diabetic foot and diabetic foot care. There is a need for awareness program for these patients not only to improve their knowledge and practices, but also to motivate patients to have a positive attitude toward diabetic foot care.
Collapse
Affiliation(s)
| | - Leila A. Alsaid
- Department of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - PJ Parameaswari
- Research Center, King Saud Medical City, Riyadh, Saudi Arabia
| | | |
Collapse
|
24
|
Megallaa MH, Ismail AA, Zeitoun MH, Khalifa MS. Association of diabetic foot ulcers with chronic vascular diabetic complications in patients with type 2 diabetes. Diabetes Metab Syndr 2019; 13:1287-1292. [PMID: 31336479 DOI: 10.1016/j.dsx.2019.01.048] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 01/23/2019] [Indexed: 12/11/2022]
Abstract
CONTEXT Diabetes mellitus is a common disease which is prevalent globally, presenting with chronic complications and constitutes a major risk to the patient. Diabetic foot ulcers are the single biggest risk factor for non-traumatic lower limb amputations in persons with diabetes. We aimed to screen for the chronic vascular diabetic complications in patients with diabetic foot ulcers (DFUs) and to assess the association of diabetic foot ulcers with these complications in the study group. SUBJECTS AND METHODS This cross-sectional study included 180 type 2 diabetic patients (aged 30-70 years) with diabetic foot ulcers who attended the Outpatient Clinic of Diabetes in Alexandria Main University Hospital. Full diabetic foot examination was done to all study subjects. DFUs were assessed using University of Texas Diabetic Wound Classification System. HbA1c, LDL-C, serum creatinine, and urinary albumin creatinine ratio (ACR) were measured for all study subjects. Estimated glomerular filtration rate (eGFR) was calculated using CKD-EPI equation. Fundus examination was done for all study subjects. RESULTS The prevalence of diabetic kidney disease (DKD) and diabetic retinopathy (DR) was 86.1% and 90% respectively among the study group. 86.7% of patients had neuropathic DFUs, 11.1% of them had ischemic DFUs and 2.2% had neuro-ischemic DFUs. Regarding diabetic peripheral neuropathy (DPN) and peripheral arterial disease (PAD) as risk factors for developing DFU, the prevalence of both of them respectively was 82% and 20% among the study group. There was statistically significant association between both DKD, DR and peripheral neuropathy. There was also statistically significant association between both DKD, DR and peripheral arterial disease (PAD). CONCLUSION Chronic vascular diabetic complications are common among type 2 diabetic patients with diabetic foot ulcers. There is statistically significant association between these complications and diabetic peripheral neuropathy (DPN) and peripheral arterial disease (PAD).
Collapse
Affiliation(s)
- Magdy H Megallaa
- Unit of Diabetes and Metabolism, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Azza A Ismail
- Unit of Diabetes and Metabolism, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mohammed H Zeitoun
- Unit of Diabetes and Metabolism, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mai S Khalifa
- Unit of Diabetes and Metabolism, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| |
Collapse
|
25
|
Saber HJ, Daoud AS. Knowledge and practice about the foot care and the prevalence of the neuropathy among a sample of type 2 diabetic patients in Erbil, Iraq. J Family Med Prim Care 2018; 7:967-974. [PMID: 30598942 PMCID: PMC6259530 DOI: 10.4103/jfmpc.jfmpc_163_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
CONTEXT Patients with diabetes need to receive medical care from collaborative, integrated teams with expertise in diabetes. They must also assume an active role in their care. One aspect of health education for diabetic patients is foot care, therefore identifying patients foot care knowledge and practice is central in diabetes management. AIMS To know level of foot care, to assess peripheral neuropathy and association between them. SETTINGS AND DESIGN Cross sectional study in Rizgary Teaching Hospital and Layla Qasim diabetic center in Erbil, Iraq. SUBJECTS AND METHODS A sample of 250 patients aged ≥ 18 years with type 2 diabetes were interviewed to complete a questionnaire about foot care. Then a Michigan Neuropathy Screening Instrument was used as screening tool to detect neuropathy. STATISTICAL ANALYSIS USED Statistical Package for Social Sciences version 25 used with a statistical significance level of < 0.05. The results presented as rates, frequencies, percentages in tables and analyzed using Chi-square test. RESULTS The mean age of the sample was 53.75 ± 12.08 years. The mean knowledge and practice scores were 6.1 ± SD 2.6 and 5.8 ± SD 2.1, respectively. The majority of participants were of poor knowledge score and moderate practice score (38% and 40%, respectively). The percentage of neuropathy was 31.20%. The neuropathy was highest among those who had low knowledge score (P < 0.05). CONCLUSIONS The mean knowledge and practice scores were moderate, knowledge had significant influence on practice. Peripheral neuropathy was significantly higher among those with low knowledge score.
Collapse
Affiliation(s)
- Hemin Jawad Saber
- Department of Family Medicine, Kurdistan Board for Medical Specialties, Erbil, Iraq
| | - Ali Shakir Daoud
- Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq
| |
Collapse
|
26
|
Fagbamigbe AF, Lawal AM, Idemudia ES. Modelling self-assessed vulnerability to HIV and its associated factors in a HIV-burdened country. SAHARA J 2018; 14:140-152. [PMID: 29050514 PMCID: PMC5678227 DOI: 10.1080/17290376.2017.1387598] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Globally, individuals' self-assessment of vulnerability to HIV infection is important to maintain safer sexual behaviour and reduce risky behaviours. However, determinants of self-perceived risk of HIV infection are not well documented and differ. We assessed the level of self-perceived vulnerability to HIV infection in Nigeria and also identified its risk factors. METHODS We explored a recent nationally representative data with self-reported vulnerability ('high', 'low' and 'no risk at all') to HIV infection as the outcome of interest. Data were weighted and association between the outcomes and the risk factors determined. We used simple ordered logit regression to model relationship between the outcome variable and risk factors, and controlled for the significant variables in multiple ordered logistic regression at 5% significance level. RESULTS About 74% had good knowledge of HIV transmission and 6% had experienced STI recently. The likelihood of assessing oneself as having 'no risk at all' was 50% and for 'high chances' was 1.6%. Self-perceived high risk of HIV was higher among those who recently experienced STI (5.6%) than those who did not (1.7%), and also higher among those who recently engaged in transactional sex and had multiple sexual partners. The odds of good knowledge of HIV transmission on high self-perceived vulnerability to HIV was 19% higher than poor knowledge (OR = 1.19, 95% CI: 1.12-1.27). Also, respondents who recently had multiple sexual partners were 72% (OR = 1.72, 95% CI: 1.60-1.86) more likely to report self as having high risk. Younger respondents aged 14-19 years had higher odds of 41% (OR = 1.41, 95% CI: 1.29-1.55) to perceive self as having high vulnerability to HIV than older respondents. CONCLUSION High vulnerability to HIV infection was reported among younger respondents, those with history of STIS and those who engage in multiple sexual relations. Despite high level of risky sexual behaviour and good knowledge of HIV transmission and prevention found in this study, self-perceived vulnerability to HIV generally is low. For the low perception found in this study to translate to low chance of HIV infection, there is need for all stakeholders to embark on risk reduction initiatives through sexual education that would minimise risky sexual practices and ensuring availability and affordability of HIV prevention methods.
Collapse
Affiliation(s)
- A F Fagbamigbe
- a MSc Medical Statistics, MPDI, PhD Biostatistics is affiliated to Faculty of Human and Social Sciences , North West University , Mahikeng , South Africa.,b Department of Epidemiology and Medical Statistics , Faculty of Public Health, College of Medicine, University of Ibadan , Ibadan , Nigeria
| | - A M Lawal
- c MSc Psycology PhD Psycology is affiliated to Faculty of Human and Social Sciences , North West University , Mahikeng , South Africa.,d Department of Psychology , Federal University , Oye-Ekiti , Nigeria
| | - E S Idemudia
- c MSc Psycology PhD Psycology is affiliated to Faculty of Human and Social Sciences , North West University , Mahikeng , South Africa
| |
Collapse
|
27
|
Vibha SP, Kulkarni MM, Kirthinath Ballala AB, Kamath A, Maiya GA. Community based study to assess the prevalence of diabetic foot syndrome and associated risk factors among people with diabetes mellitus. BMC Endocr Disord 2018; 18:43. [PMID: 29940924 PMCID: PMC6020220 DOI: 10.1186/s12902-018-0270-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/12/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Diabetic foot is one of the most significant and devastating complication of diabetes. The objective of this study was to assess the prevalence of diabetic foot syndrome (DFS) and the associated risk factors among people with diabetes mellitus. METHODS A community based cross-sectional study was carried out among 620 subjects with diabetes mellitus (DM) in rural areas of Udupi district. The Michigan Neuropathy Screening Instrument was used to identify peripheral neuropathy. Ankle brachial index was used to identify peripheral arterial disease (PAD). Subjects with diabetic foot syndrome were classified according to the International Working Group on Diabetic Foot (IWGDF) classification system. RESULTS The overall prevalence of DFS was 51.8%. Among them 31.3, 11.9 and 8.5% belonged to category 1, 2 and 3 respectively. Multivariate logistic regression analysis showed advancing age, low socio-economic status, sedentary physical activity and longer duration of DM were significant independent correlates of DFS. CONCLUSION The overall prevalence of DFS was high among the study population; hence the screening for foot complications should start at the time of diagnosis of diabetes integrated with sustainable patient education at primary care level by training of health care providers at primary care level.
Collapse
Affiliation(s)
- S. P. Vibha
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
| | - Muralidhar M. Kulkarni
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
| | - A. B. Kirthinath Ballala
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
| | - Asha Kamath
- Department of Statistics, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
| | - G. Arun Maiya
- Department of Physiotherapy, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
| |
Collapse
|
28
|
Knowledge and Practice of Diabetic Foot Care in Patients with Diabetes at Chinese General Hospital and Medical Center. J ASEAN Fed Endocr Soc 2017; 32:123-131. [PMID: 33442095 PMCID: PMC7784107 DOI: 10.15605/jafes.032.02.05] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 07/27/2017] [Indexed: 12/18/2022] Open
Abstract
Objective The objective of this study is to measure the level of knowledge and practice of diabetic foot self-care and determine the factors that affect the level and knowledge and practice of diabetic foot self-care among among patients with diabetes.. Methodology Three hundred thirty adult patients with diabetes at the outpatient clinics were given self-administered questionnaires on knowledge and practice of diabetic foot self-care. The scores were computed based on their answers. A score of >70% was gauged as good, 50 to 70% as satisfactory and <50% as poor. Results Of the subjects, 82.7% had good foot care knowledge, 22.4% had good foot self-care practice, and 71% had satisfactory practice score. Patients who received diabetes education were twice as likely to have a good knowledge score (OR 2.41, 95% CI, 1.09 to 5.32; p=0.03). Compared to patients who received diabetes care in private clinics, those who attended the charity outpatient clinic were nearly three times as likely to have a good knowledge score (OR 2.8, 95% CI, 1.32 to 5.96; p=0.007). Patients with known diabetes for more than ten years and those with a family history of diabetes were 50% less likely to have good practice scores (OR 0.50, 95% CI, 0.28 to 0.90; p=0.021 and OR 0.49, 95% CI, 0.29 to 0.83; p=0.008, respectively). Conclusion The current state of foot care knowledge in Filipino respondents with diabetes is good but the level of foot self-care practice is only satisfactory.
Collapse
|
29
|
Sekhar M S, MK U, Vyas N, Rodrigues GS. Development and Evaluation of Patient Information Leaflet for Diabetic Foot Ulcer Patients. Int J Endocrinol Metab 2017; 15:e55454. [PMID: 29201075 PMCID: PMC5702454 DOI: 10.5812/ijem.55454] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 04/10/2017] [Accepted: 05/24/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Patient education (PE) is as important as medical and surgical interventions in the management of diabetic foot ulcer (DFU). Patient information leaflets (PILs) are globally accepted patient counseling aids. OBJECTIVES This study aimed at developing PILs for DFU patients and investigating its validation. METHODS The PILs were prepared based on different model leaflets available from various online resources, including "Patient UK". The PILs readability was evaluated by Flesch/ Flesch-Kincaid readability (FRE/FK-GL) method before user-testing (n = 34 DFU patients) by quasi-experimental methods in patients with DFU. Additionally, user-opinion on legibility and content of the PIL was also determined. Baker Able Leaflet Design (BALD) method was employed to assess the layout and design characteristics of the PIL. RESULTS The best FRE score achieved was 73.9 and the FK-GL score was 6.1. The mean BALD assessment score for English and Kannada versions of PIL were 27 and 26, respectively. The ICC of the test-retest reliability of user-testing and user-opinion questionnaires in both English and Kannada ranged from 0.91 to 0.96. The overall user-testing knowledge-based mean score significantly improved from 43.4 to 69.7 (P < 0.05). Overall, 82.4% of patients reported overall user-opinion on legibility and content of the PIL as good. CONCLUSIONS The developed PILs met the criteria of fairly easy readability and good layout design. The user-opinion of the majority of patients reported the PIL content, legibility, and design as good. The Pictogram-based PILs (P-PILs) was found to be an effective PE tool in DFU patients.
Collapse
Affiliation(s)
- Sonal Sekhar M
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, India
- Corresponding author: Sonal Sekhar M, Assistant Professor-Selection Grade, Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, India-576104. Tel: +91-8202922482, Fax: +91-8202571998, E-mail:
| | - Unnikrishnan MK
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, India
| | - Navya Vyas
- Department of Public Health, Manipal University, Manipal, India
| | - Gabriel Sunil Rodrigues
- Department of Surgery, Kasturba Medical College Hospital, Manipal University, Manipal, India
| |
Collapse
|
30
|
Qureshi MS, Iqbal M, Zahoor S, Ali J, Javed MU. Ambulatory screening of diabetic neuropathy and predictors of its severity in outpatient settings. J Endocrinol Invest 2017; 40:425-430. [PMID: 27848229 DOI: 10.1007/s40618-016-0581-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 11/02/2016] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Diabetic neuropathy is one of the most common causes of chronic neuropathic symptomatology and the most disabling and difficult-to-treat diabetic microangiopathic complication. The neuropathies associated with diabetes are typically classified into generalized, focal and multifocal varieties. There exists a scarcity of literature studying the correlation of different patient- and disease-related variables with severity of neuropathy. OBJECTIVES This study aims to delineate the prevalence of diabetic neuropathy in type 2 diabetes, describe its characteristics and find out predictors of its severity. MATERIAL AND METHODS Eight hundred consecutive diabetic patients presenting to outpatient department (OPD) of Khan Research Labs (KRL) General Hospital and Centre for Diabetes and Liver diseases, Islamabad, during March-June, 2015 were made to complete a self-administered questionnaire (Michigan Neuropathy Screening Instrument-MNSI) and underwent a thorough physical examination according to MNSI protocols. A score of >2 was considered to be diagnostic for DPN. Patient and disease variables were noted. MNSI score was used as an index of severity of diabetic peripheral neuropathy (DPN). Correlation of several patient- and disease-related variables with the severity of DPN was determined using multivariate regression. RESULTS Out of a total 800 patients screened, 90 (11.25%) were found to have diabetic neuropathy. Of these 90, 45.5% were males, the median age was 54.47 ± 10.87 years and the median duration of diabetes was 11.12 ± 9.8 years. The most common symptom was found to be numbness (63.6%) followed by generalized body weakness (61.5%). The common findings on physical examination were dry skin/callus (38.7%) and deformities (14.7%). Duration of diabetes was found to be the strongest predictor for development and severity of diabetic neuropathy followed by glycemic controls (HbA1c values) and age. CONCLUSION Duration of diabetes rather than diabetic controls predicts better the development and severity of diabetic neuropathy indicating a failure of intensive treatment to avert such complications.
Collapse
Affiliation(s)
- M S Qureshi
- Department of Medicine, Khan Research Laboratories (KRL) Hospital, Islamabad, 44000, Pakistan
| | - M Iqbal
- Centre for Diabetes and Liver Diseases, Islamabad, 44000, Pakistan
| | - S Zahoor
- Department of Medicine, Khan Research Laboratories (KRL) Hospital, Islamabad, 44000, Pakistan.
| | - J Ali
- Department of Medicine, Khan Research Laboratories (KRL) Hospital, Islamabad, 44000, Pakistan
| | - M U Javed
- Department of Medicine, Khan Research Laboratories (KRL) Hospital, Islamabad, 44000, Pakistan
| |
Collapse
|
31
|
Taksande BA, Thote M, Jajoo UN. Knowledge, attitude, and practice of foot care in patients with diabetes at central rural India. J Family Med Prim Care 2017; 6:284-287. [PMID: 29302533 PMCID: PMC5749072 DOI: 10.4103/2249-4863.219994] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Diabetic foot syndrome is one of the common and most devastating preventable complications of diabetes mellitus (DM). It is associated with morbidity and premature mortality due to long-term complications affecting foot. The American Diabetes Association recommends that people with diabetes should have a comprehensive foot examination once per year. Most of the foot problems can be prevented with careful foot care. It may take effort and time to build up good foot care habits, but self-care is essential. Aim: The main aim of the study is to analyze the knowledge, attitude, and practice of foot care in patients with DM in central rural India. Methodology: This study was conducted at a rural educational hospital in central part of India over 200 patients who have Type 1 and Type 2 diabetes. They were evaluated for their knowledge about foot care and footwear practices. A structured and validated questionnaire was administered to cases. Results: Around 82.9% of the patients were aware of the disease and 23.2% were aware of the complications of the DM. In 63% of the patients, foot care examination and education regarding foot complications were not suggested by their treating physicians. Annual examination of feet by the physician and self-examination were not known facts to the diabetic population. Conclusion: It is necessary to firstly develop awareness of diabetes mellitus and the related complications, one amongst which is foot care. Certain educational strategies should be established for both the consultant physician and also the common man to create awareness for effective foot care.
Collapse
Affiliation(s)
- Bharati Amar Taksande
- Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Mukesh Thote
- Consultant Physician, Bhandara, Maharashtra, India
| | - U N Jajoo
- Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| |
Collapse
|
32
|
Solanki JD, Sheth NS, Shah CJ, Mehta HB. Knowledge, attitude, and practice of urban Gujarati type 2 diabetics: Prevalence and impact on disease control. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2017; 6:35. [PMID: 28584835 PMCID: PMC5441203 DOI: 10.4103/jehp.jehp_101_15] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
CONTEXT Type 2 diabetes is the modern epidemic wherein patient care needs multiple approaches, education, and self-awareness being one of them. There are some knowledge, attitude, and practice (KAP) studies from India but very few relating it with disease control. AIMS We tried to study KAP of treated type 2 diabetics and its correlation with glycemic control. SETTINGS AND DESIGN Cross-sectional KAP study. SUBJECTS AND METHODS We formulated KAP questionnaires in the form of KAP - 10 points for each and total 30. We recruited 200 type 2 diabetics (96 males, 104 females) treated by MD physicians with known current glycemic status. They were asked KAP questionnaires one to one by a direct interview in local language and results were associated with various factors and glycemic control. RESULTS KAP score on was average 19 out of 30 in type 2 diabetics having mean age 58 years, mean duration 9 years. KAP score was unaffected by gender, occupation, duration of disease but significantly affected by current age, and education level. Only 40% patients had good glycemic control who scored better KAP than poor glycemic. There was positive correlation between KAP score and glycemic control, with significance for only glycosylated hemoglobin and not fasting blood sugar, postprandial blood sugar. CONCLUSIONS Physician treated type 2 diabetics of our region had moderate KAP score, affected by age, education which suggested to affect glycemic control. Lacunae in knowledge regarding incurability of disease, attitudes toward complication, self-care, and good practices like walking, enriching knowledge need improvement so as an optimum glycemic control.
Collapse
Affiliation(s)
- Jayesh Dalpatbhai Solanki
- Department of Physiology, Government Medical College, Bhavnagar, Gujarat, India
- Address for correspondence: Dr. Jayesh Dalpatbhai Solanki, F1, Shivganga Apartments, Plot No. 164, Bhayani Ni Waadi, Opposite Bawaliya Hanuman Temple, Gadhechi Wadlaa Road, Bhavnagar - 364 001, Gujarat, India. E-mail:
| | | | - Chinmay J. Shah
- Department of Physiology, Government Medical College, Bhavnagar, Gujarat, India
| | - Hemant B. Mehta
- Department of Physiology, Government Medical College, Bhavnagar, Gujarat, India
| |
Collapse
|
33
|
D'Souza M, Kulkarni V, Bhaskaran U, Ahmed H, Naimish H, Prakash A, S T, Dahiya B, Thapar R, Mithra P, Kumar N, Holla R, Bb D, Kumar A. Diabetic Peripheral Neuropathy and its Determinants among Patients Attending a Tertiary Health Care Centre in Mangalore, India. J Public Health Res 2015; 4:450. [PMID: 26425491 PMCID: PMC4568420 DOI: 10.4081/jphr.2015.450] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 04/28/2015] [Accepted: 05/06/2015] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The burden of diabetes mellitus (DM) is on the rise especially in developing countries like India. Due to its chronic nature DM tends to cause many debilitating complications and diabetic peripheral neuropathy (DPN) is one of them. The aim of this study is to determine the prevalence of DPN among patients attending a tertiary care hospital and to identify the determinants associated with it. DESIGN AND METHODS A cross sectional study was conducted in Government Wenlock Hospital, Mangalore (India), during January-February 2014. A total of 208 patients with >5 year duration of DM were asked to respond to the patient history version of Michigan Neuropathy Screening Instrument (MNSI) and examinations were conducted after obtaining consent from them. The statistical analysis was done in terms of descriptive statistics and association between variables was tested using logistic regression test. RESULTS The prevalence of DPN using the MNSI history version and MNSI examination were found to be 18.3% and 32.2% respectively. The major determinants associated with DPN were found to be male gender (OR: 2.7, CI: 1.4-5.1, P=0.001), smoking (OR: 5.8, CI: 1.9-17.3, P=0.001) and age >40 years (OR: 2.7, CI: 1.2-5.8, P=0.011). CONCLUSIONS The burden of undetected DPN was found to be higher among diabetics, with an especially higher prevalence among males, smokers and those with long standing diabetes mellitus. Interventions in the form of early detection through routine screening, smoking cessation and regular follow up examinations would go a long way in reducing the burden of disability among diabetics and improve their quality of life significantly. Significance for public healthThe findings of the current research hold importance since diabetes is one of the leading causes of morbidity and mortality across the world. Due to its chronic nature and effects of hyperglycaemia, diabetes tends to be associated with many comorbidities, like peripheral neuropathy, nephropathy, retinopathy etc. The presence of diabetic peripheral neuropathy leads to a reduced quality of life among diabetic patients due to the trauma and consequent gangrenes andamputation. The concept of secondary prevention can be applied to the prevention of diabetic peripheral neuropathy using easy to apply screening tools and thus help in early diagnosis and treatment to reduce the burden of this debilitating illness.
Collapse
Affiliation(s)
- Monisha D'Souza
- Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India
| | - Vaman Kulkarni
- Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India
| | - Unnikrishnan Bhaskaran
- Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India
| | - Humam Ahmed
- Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India
| | - Hegde Naimish
- Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India
| | - Anjali Prakash
- Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India
| | - Tabreez S
- Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India
| | - Bhanu Dahiya
- Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India
| | - Rekha Thapar
- Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India
| | - Prasanna Mithra
- Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India
| | - Nithin Kumar
- Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India
| | - Ramesh Holla
- Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India
| | - Darshan Bb
- Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India
| | - Avinash Kumar
- Department of Community Medicine, Kasturba Medical College, Manipal University , Mangalore, India
| |
Collapse
|
34
|
Infection and Foot Care in Diabetics Seeking Treatment in a Tertiary Care Hospital, Bhubaneswar, Odisha State, India. ADVANCES IN PUBLIC HEALTH 2015. [DOI: 10.1155/2015/765145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Diabetes mellitus is a major public health problem that can cause a number of serious complications. Foot ulceration is one of its most common complications. Poor foot care knowledge and practices are important risk factors for foot problems among diabetics. The present study was undertaken in the diabetes outpatient department of a tertiary care hospital to assess the practices regarding foot care in diabetes, find out the determinants of foot ulcer in diabetics, and offer suggestions to improve care. After informed consent, a total of 124 diabetics were interviewed to collect all relevant information. The diabetic foot care practice responses were converted into scores and for the sake of analysis were inferred as poor (0–5), fair (6-7), and good (>7) practices. Of the study population, 68.5% (85/124) consisted of men. The disease was diagnosed within the last 5 years for 66% (81/124) of the study participants. Of the study subjects, 83% (103/124) were on oral hypoglycemic agents (OHAs), 15.3% (19) on insulin, and 2 on diet control only. Among them about 18.5% had a history of foot ulcer. 37.9% reported using special slippers, 12% diabetics used slippers indoors, and 66.9% used slippers while using toilet. Of the study subjects, 67.8% said that feet should be inspected daily. 27.4% said they regularly applied oil/moisturizer on their feet. There is a need on part of the primary or secondary physician and an active participation of the patient to receive education about foot care as well as awareness regarding risk factors, recognition, clinical evaluation, and thus prevention of the complications of diabetes.
Collapse
|