Foot health in diabetes mellitus: epidemiological and educational aspects

Mendel Baba

    Research output: ThesisDoctoral Thesis

    1054 Downloads (Pure)


    [Truncated] Diabetes mellitus (DM) is a global health problem that can lead to a multitude of complications. DM contributes to the development of diabetic peripheral neuropathy (DPN) and peripheral arterial disease (PAD) in the lower extremities, which in turn increases the risk of foot complications such as ulceration, infection and lower extremity amputation (LEA). These complications are particularly debilitating for the patient as they have a significant impact on mobility and quality of life, while also contributing disproportionately to the costs of diabetes care. Reducing the burden of foot complications for both the individual and health care providers is thus a fundamental goal of government and health care organisations worldwide. Achieving this goal is a complex and multifaceted task, however three practical approaches to addressing this issue involve supporting the patient to care for their feet, improving diabetes management and education, and expanding the evidence base to assist clinical decision making.

    Early detection of foot problems, and their timely management, plays an important role in reducing the incidence of complications. To this end, improving patient awareness of their foot health is a critical component of diabetes management. A lack of patient awareness increases the risk of a greater number of complications, and potentially leads to more severe outcomes. Determining awareness of foot health, and patient perceptions of their feet, will provide a better understanding of possible barriers to optimal foot care. In this thesis, a cross sectional investigation of awareness of foot health in a cohort of patients with type 2 diabetes is first presented. The characteristics of patients who believed their feet were normal and abnormal, and gaps in patient knowledge, were assessed. The results demonstrate that a large majority of patients who considered their feet normal had features on inspection such as deformity, dry skin, callouses and skin fissures that could promote more serious complications. Most patients with self-reported normal feet had objective evidence of peripheral sensory neuropathy, and smaller proportions had peripheral arterial disease and a combination of neuropathy and arteriopathy.
    Original languageEnglish
    • Foley, Laurence, Supervisor
    • Davis, Wendy, Supervisor
    • Davis, Timothy, Supervisor
    Publication statusUnpublished - May 2015


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