Assessment of Prevalence, Associations ,Knowledge, and Practices about Diabetic Foot Disease in a Tertiary Care Hospital in Colombo, Sri Lanka

Abstract

Background. One in five adults in Sri Lanka has either diabetes or prediabetes, and one-third of those with diabetes are undiagnosed. Diabetic foot is a debilitating condition affecting up to 50% of patients with both type 1 and type 2 diabetes. The risk of nontraumatic lower limb amputations is 15 times higher in diabetic patients when compared with nondiabetics. Patient education about correct foot care practices is the cornerstone of prevention of diabetic foot disease. Objective. To assess the prevalence of diabetic foot disease, knowledge, and practices about diabetic foot care among diabetic patients. Methods. 334 patients attending the diabetic clinic in Colombo South Teaching Hospital were recruited according to the inclusion and exclusion criteria. Data were collected using 3 questionnaires, and they were filled using the foot examination findings, patients’ medical records, and direct interviewing of the patients. Results. The mean age of the patients included in the study was $58.23\pm 10.65$ years while the median duration of diabetes was $10.54\pm 7.32$ years. 34.1% patients had peripheral neuropathy, and 29.5% had peripheral vascular disease. Diabetic foot disease according to the WHO definition was present only in 23 (6.9%) patients. There was a significant association between peripheral neuropathy and current or past foot ulcer which took more than 2 weeks to heal ( $p<0.05$ ). Knowledge about foot care was less among the studied population, and it was associated with poor foot care practices. Presence of diabetic foot and current or past foot ulcer which took more than 2 weeks to heal were significantly associated with the foot care knowledge and practices ( $p<0.05$ ) Conclusion. Improvement of patients’ knowledge about foot care and their practices have a significant impact on the reduction of diabetic foot disease.