Shaki Omna, Gupta Gayatri Karad, Rai Sanjay K, Gupta Tej Pratap, Kumar R Vijay, Upreti Vimal, Bajpai Mukul
Medical Officer, 151 Base Hospital, Guwahati, Assam, India.
Department of Consultant Dermatologist, Skin Diseases Centre, Nashik, Maharashtra, India.
J Family Med Prim Care. 2022 May;11(5):1834-1841. doi: 10.4103/jfmpc.jfmpc_1883_21. Epub 2022 May 14.
About 10% of patients with type 2 diabetes mellitus at the time of diagnosis have more than one risk factor for developing foot ulceration, and it increases to 15% in a lifetime. The risk of development of Diabetic foot ulcers/gangrene can be prevented by the patient's self-foot care practice at home. The present study aimed to determine the prevalence of awareness of self-foot care practice among diabetic patients in a rural setting. The study also aimed to identify the factors preventing dry or wet diabetic gangrene development and subsequent amputation.
A hospital-based cross-sectional study was carried out among 1687 people with diabetes mellitus (DM) who attended orthopedic and diabetic OPD in a tertiary care hospital in Kamrup, Assam, India. An appropriate self-explanatory questionnaire about knowledge of self-foot care practice was given to all study participants. Foot examination was performed by authors participated in the study on all patients. The observations and results were categorized according to the International Diabetes Federation foot risk categories.
Of 1687 patients included in this study, 298 (17.7%) had foot ulcers of various grades, 164 (9.76%) had peripheral vascular disease, and 484 (28.7%), had peripheral neuropathy of different grades. After multivariate analysis, patients on insulin and combination therapy and peripheral neuropathy were significantly associated with the presence of foot ulcers. The mean knowledge score was as low as 9.7 ± 4.8 out of a total score of 23. Low awareness and knowledge were associated with low mean scores due to a lack of formal education (8.3 ± 6.1). Among the 1687 patients, only 381 (22.5%) are aware and have some knowledge about self-foot care, and 686 (40.6%) had their feet examined by a doctor only once since their initial diagnosis. The incidence of development of diabetic-related complications was significantly low in those who know about foot self-care as well as those whose feet had been inspected by a physician at least once.
The incidence of development of diabetic-related complications was significantly low in those who know about foot self-care as well as those whose feet had been examined by a physician of family doctors at least once. There is a need to educate all patients of diabetes about self-foot care. It is prudent to establish an integrated foot care services within primary care centers and in the diabetic clinic to identify feet at risk, institute early preventive measures, and provide continuous foot care education through images videos on WhatsApp to patients and primary health care givers.
2型糖尿病患者在确诊时约10%有不止一种发生足部溃疡的风险因素，一生中这一比例会升至15%。糖尿病足溃疡/坏疽的发生风险可通过患者在家中的自我足部护理措施来预防。本研究旨在确定农村地区糖尿病患者自我足部护理措施的知晓率。该研究还旨在确定预防干性或湿性糖尿病坏疽发展及后续截肢的因素。
在印度阿萨姆邦卡姆鲁普一家三级护理医院的骨科和糖尿病门诊，对1687名糖尿病患者开展了一项基于医院的横断面研究。向所有研究参与者发放了一份关于自我足部护理知识的恰当且自解释性的问卷。参与研究的作者对所有患者进行了足部检查。观察结果和结果根据国际糖尿病联盟足部风险类别进行分类。
本研究纳入的1687名患者中，298名（17.7%）有不同程度的足部溃疡，164名（9.76%）有外周血管疾病，484名（28.7%）有不同程度的外周神经病变。多因素分析后，使用胰岛素和联合治疗的患者以及外周神经病变与足部溃疡的存在显著相关。知识总分23分的情况下，平均知识得分低至9.7±4.8分。由于缺乏正规教育，低知晓率和知识水平与低平均分相关（8.3±6.1）。在1687名患者中，只有381名（22.5%）知晓并对自我足部护理有一定了解，686名（40.6%）自初次诊断以来仅由医生检查过一次足部。了解足部自我护理的患者以及足部至少由医生检查过一次的患者中，糖尿病相关并发症的发生率显著较低。
了解足部自我护理的患者以及足部至少由家庭医生检查过一次的患者中，糖尿病相关并发症的发生率显著较低。有必要对所有糖尿病患者进行自我足部护理教育。在初级保健中心和糖尿病诊所建立综合足部护理服务，以识别有风险的足部、采取早期预防措施，并通过WhatsApp上的图像视频向患者和初级卫生保健提供者提供持续的足部护理教育，是审慎之举。
