Endocrine Abstracts

Introduction: Diabetic foot is known to represent a serious complication of diabetes mellitus, responsible for significant morbidity, disability and considerable financial implications. The prevention of this complication requires, first and foremost, a good patient education.

Objective: To evaluate the current state of knowledge and practices of foot care in diabetic patients and to identify factors associated with a good educational level.

Patients and methods: A transversal descriptive study was conducted in two centers, over a period of two months in 2018, including 70 diabetic patients without a prior history of foot ulcer or amputation. A questionnaire survey was designed including general knowledge questions about the importance of foot examination, mechanisms and clinical manifestations of the diabetic foot, in addition to 18 questions about foot care.

Results: The average age of the participants was 51.9±16.6 years. The sex ratio was 0.66 (40% men and 60% women). Most patients had type 2 diabetes mellitus (78.6%). The mean duration of diabetes was 11.5±7.7 years. Therapeutic education for diabetic foot was done in only 15.7% of cases. Half of patients didn’t know any mechanism of diabetic foot while 37.1% of them didn’t know any clinical manifestations. Only 11% of patients had a theoretical knowledge level higher than average. Practice level was average in the majority of cases (60%) with less than 10% of patients cutting their nails with a non-metallic object or using appropriate shoes or footwear. Having a medium or good overall educational level was significantly associated with higher education level (P=0.002), urban area of residence (P=0.05), type 1 diabetes (P=0.027) and prior hospitalization for diabetes (P=0.038).

Conclusion: The overall level of knowledge and practice was relatively insufficient, especially regarding the knowledge level. Therapeutic education, despite its importance, is not as optimal as it should be whether in Tunisia or around the world for multiple reasons.