Is walking barefoot a risk factor for diabetic foot disease in developing countries?

Jayasinghe, Saroj; Atukorala, Inoshi; Gunethilleke, Bhagya; Siriwardena, Viraj; Herath, Samantha; Abrew, Kusum de

doi:10.22605/rrh692

Cited by 32 publications

(29 citation statements)

References 9 publications

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“…We also found that wearing slippers as opposed to sandals and covered shoes increases the risk of foot ulceration about 3-4 times. This is supported by a previous finding suggesting the use of appropriate footwear and wearing them indoors as well as outdoors to prevent foot ulcers [22]. …”

Section: Discussionsupporting

confidence: 83%

“…However, none of these studies have shown these as predictors of foot ulcers, as diabetic ulcer disease seems to have a complicated aetiology, to which a number of structural, pathophysiological, behavioral and environmental factors contribute [19]. Longer duration of diabetes and poor level of education [8], prolonged hyperglycemia [20], inappropriate footwear [21], walking barefoot [22], weak pedal pulses [23], skin changes of the foot [21], presence of callus [24], Charcot deformity [25] and reduced ankle mobility [26] are some of the other common factors documented.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of Diabetic Foot and Leg Ulcers in a Developing Country with a Rapid Increase in the Prevalence of Diabetes Mellitus

et al. 2013

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ObjectiveTo identify the socio demographic, life style and foot examination related predictors of diabetic foot and leg ulcers with a view to develop a screening tool appropriate for the use in an outpatient setting.Research design and methodsThis cross sectional study included type 2 diabetes mellitus (DM) patients; 88 subjects with leg and foot ulcers and 80 non ulcer controls. Socio demographic data and life style factors were documented. Foot was examined for skin changes and structural abnormalities. Distal peripheral neuropathy was assessed by pressure sense, vibration sense and joint position sense. Multivariate analysis by logistic regression was used to determine the significant predictors in screening for foot ulcers.ResultsEducation of grade 6 and below (OR - 1.41, 95% CI; 1.03 - 4.68), low income (OR - 23.3, 95% CI; 1.5 - 34.0), impaired vibration sense (OR - 24.79, 95% CI; 9.3 - 66.2), abnormal monofilament test on first (OR - 1.69, 95% CI; 1.36 - 16.6), third (OR - 3.4, 95% CI; 1.1 - 10.6) and fifth (OR - 1.8, 95% CI; 1.61- 12.6) toes are found to be predictors of increased risk whereas incidental diagnosis of DM (OR - 0.03, 95% CI; 0.003 - 0.28), wearing covered shoes (OR - 0.003, 95% CI; 0.00 - 0.28), presence of normal skin color (OR - 0.01, 95% CI; 0.001 - 0.14) and normal monofilament test on first metatarsal head (OR - 0.10, 95% CI; 0.00 - 0.67) are protective factors for ulcers.ConclusionsTen independent risk and protective factors identified in this study are proposed as a simple screening tool to predict the risk of developing leg and foot ulcers in patients with DM.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Predictors of Diabetic Foot and Leg Ulcers in a Developing Country with a Rapid Increase in the Prevalence of Diabetes Mellitus

et al. 2013

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“…Here, the results should be interpreted with caution, because Muslims wash their feet and toes at least five times a day for their prayers. In this study, few patients had indoor and outdoor barefoot-walking habits, though these patients were much fewer compared to other studies reported elsewhere 45,46. Of these patients, the majority had poor knowledge and did not get advice from their physicians.…”

Section: Discussioncontrasting

confidence: 58%

Prevalence of diabetic comorbidities and knowledge and practices of foot care among diabetic patients: a cross-sectional study

Abdulghani¹,

Alrajeh²,

Alsalman³

et al. 2018

DMSO

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BackgroundDiabetes mellitus with comorbid complications constitute a major public health problem worldwide. The aim of this study was to evaluate the risk of comorbid complications with glycosylated hemoglobin levels and diabetes duration. Also assessed were patients’ diabetic foot-care knowledge and practices.Patients and methodsThis was a quasiexperimental study. A total of 360 type 2 diabetes mellitus patients were interviewed at a government health care center in Riyadh, Saudi Arabia. Diabetic complications and HbA1c-level data were collected from hospital records. A standard questionnaire was used to assess their diabetic foot-care knowledge and practice.ResultsOf the type 2 diabetes mellitus patients, 32.5% had highly uncontrolled glycosylated hemoglobin (HbA1c) levels (≥8.6%) and 62.8% had had diabetes >10 years. The patients had comorbid complications, such as hypertension (61.4%), dyslipidemia (58.6%), retinopathy (23.3%), heart disease (14.4%), and severe foot complications (3.9%). The majority of highly uncontrolled HbA1c-level patients had retinopathy (OR 8.90, P=0.0001), foot complications (OR 8.09, P=0.0001), dyslipidemia (OR 2.81, P=0.010), and hypertension (OR 2.0, P=0.028) compared to the controlled HbA1c-level (<7%) group. Patients with diabetes >10 years also had higher prevalence of foot complications (OR 2.92, P=0.0001), retinopathy (OR 2.17, P=0.011), and hypertension (OR 1.67, P=0.033). From patient responses, physicians examined only 34.2% of patient feet and 36.7% of patients received physicians advice for foot care. About 70% of patients had knowledge of diabetic foot care; however, only 41.7% of patients always examined their feet, 41.4% washed feet with warm water, 31.4% carefully dried between the toes, and 33.1% were using foot-moisturizing substances.ConclusionThe prevalence of comorbid complications was higher in the Saudi population compared to other international studies. Also, foot-care practice was not satisfactory. Therefore, there is need of improvement and increased awareness among physicians and patients to check regularly for proper care of the diabetic foot to avoid diabetic foot-related complications.

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“…From the 71 included studies, 24 studies evaluated the association of specific variables with DFU development (Table ), 14 studies with DFU recurrence or re‐ulceration (Table ), 15 studies with active or recently healed DFU (Table ), 8 studies with active or past DFU history (Table ) and 10 studies with DFU history (Table ).…”

Section: Resultsmentioning

confidence: 99%

Predictive factors for diabetic foot ulceration: a systematic review

Monteiro‐Soares

Boyko

Ribeiro

et al. 2012

Diabetes Metabolism Res

261

242

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Improving ability to predict and prevent diabetic foot ulceration is imperative because of the high personal and financial costs of this complication. We therefore conducted a systematic review in order to identify all studies of factors associated with DFU and assess whether available DFU risk stratification systems incorporate those factors of highest potential value. We performed a search in PubMed for studies published through April 2011 that analysed the association between independent variables and DFU. Articles were selected by two investigators-independently and blind to each other. Divergences were solved by a third investigator. A total of 71 studies were included that evaluated the association between diabetic foot ulceration and more than 100 independent variables. The variables most frequently assessed were age, gender, diabetes duration, BMI, HbA(1c) and neuropathy. Diabetic foot ulceration prevalence varied greatly among studies. The majority of the identified variables were assessed by only two or fewer studies. Diabetic neuropathy, peripheral vascular disease, foot deformity and previous diabetic foot ulceration or lower extremity amputation - which are the most common variables included in risk stratification systems - were consistently associated with diabetic foot ulceration development. Existing diabetic foot ulceration risk stratification systems often include variables shown repeatedly in the literature to be strongly predictive of this outcome. Improvement of these risk classification systems though is impaired because of deficiencies noted, including a great lack of standardization in outcome definition and variable selection and measurement.

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Is walking barefoot a risk factor for diabetic foot disease in developing countries?

Abstract: Is walking barefoot a risk factor for diabetic foot disease in developing countries?

Cited by 32 publications

References 9 publications

Predictors of Diabetic Foot and Leg Ulcers in a Developing Country with a Rapid Increase in the Prevalence of Diabetes Mellitus

Predictors of Diabetic Foot and Leg Ulcers in a Developing Country with a Rapid Increase in the Prevalence of Diabetes Mellitus

Prevalence of diabetic comorbidities and knowledge and practices of foot care among diabetic patients: a cross-sectional study

Predictive factors for diabetic foot ulceration: a systematic review

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