This study assessed foot self-care knowledge and practices in 350 Saudi patients with diabetes referred to a specialized diabetes care center. While 42.6% had excellent knowledge of how diabetes affects foot health, only 17.7% demonstrated good ability to identify and apply appropriate foot self-care practices. Most patients acquired knowledge through media rather than primary health care clinics. The quality of knowledge from primary care clinics did not translate to better ability to practice self-care compared to other sources of knowledge. The study concludes current foot self-care education and knowledge is unsatisfactory and calls for a national diabetes control program delivering unified, evidence-based education through healthcare providers and media to prevent limb loss.

1. EVALUATION OF FOOT SELF CARE
KNOWLEDGE AND PRACTICES IN
SAUDI PATIENTS WITH DIABETES MELLITUS
ACCORDING TO THE SOURCE OF
KNOWLEDGE
Sheshah Eman¹, Madanat Amal¹, AL- Fawaz Laila¹,
¹AL- Qaisi Dalal¹, Al- Zahrani Eman¹, Al-Esmary Reem
Diabetes Care Center, Prince Salman Hospital-(DCC-PSH)¹
MOH, Riyadh-KSA
1
EP477
EWMA-GENAUPP 2014

2. AIMS
The prevalence of Diabetes mellitus(DM) is rising
worldwide including Saudi Arabia. (1 , 2)
Consequently diabetes complications are expected
to rise, among which diabetic foot is a major
problem that leads to disability ,mortality and
economic burden.(3) A comprehensive approach to
prevent limb loss in diabetics includes foot self-
care (FSC) education, (4,5) its efficacy is proven,(6,7,8)
however , often overlooked in busy primary health
care clinics (PHCC).
 To assess the level of foot self-care knowledge
,the ability to identify and apply appropriate (FSC)
practices in Saudi patients with DM referred from
(PHCC) to a specialized diabetes care center (DCC).
 To compare the ability to identify and apply
appropriate (FSC) practices according to the source
of knowledge (SK).
BACKGROUND
EWMA-GENAUPP 20142

3. The study was performed at the DCC-PSH on 350 male
and female Saudi patient with DM. 92.9% had type 2
DM. Duration of DM was 7.27 years.22.6 % were
illiterate,31.7% completed secondary school. 37.1% had
Hypertension and 56.3% had dyslipidemia.SPSS-17 was
used for statistical analysis. Levels of knowledge were
evaluated using a modified Likert-scale.
Subjects and Methods
Results:
EWMA-GENAUPP 2014
While 42.6% of patients had excellent levels of
understanding the effect of DM on foot health (Fig 1),
Only 17.7% demonstrated good levels of ability to
identify and apply appropriate FSC practices.(Fig 2)
Fig 1: The Levels of FSC
knowledge
Fig 2 The ability to apply FSC
knowledge
42.6% 17.7%
3

4. Primary Health
Care source
Compared to:
1.Media 0.14 0.14 <0.818
2.Personal/Relative’s
Experience
0.41 0.15 <0.060
3. Non 0.67** 0.17 <0.0001
Although patients should receive FSC-education
and training at the PHCC, the majority acquired their
(FSC) knowledge through the media 36.3%.Fig3
The Level of Foot self care knowledge according to the source of knowledge
However the quality of knowledge acquired at the PHCC
was not translated in better ability to identify and apply
FSC- practices , and did better only in comparison with
those who lacked a source of FSC knowledge p<0.0001.Tab:1
Fig 3.
19%
36.3%
26.9%
17.1%
Results
P
4
The ability to apply FSC- practices in patients who acquired knowledge at
PHCC compared to other the sources of knowledge
Table 1:

5. EWMA-GENAUPP 2014
1. Shaw J E, Sicree RA, Zimmet PZ .Diabetes Atlas, Global estimates of the prevalence of diabetes
for 2010 and 2030.diabetes research and clinical practice.14-4(2010) 87.
2. Nasser M AL-Daghril, Omar S.AL-Attas, Majed S .ALokail et al .Diabetes mellius type 2 and other
chronic non- communicable diseases in the central region, Saudi Arabia( Riyadh cohort 2:) a
decade of an epidemic .BMC Medicine 2011, 9:76.
3. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA 2005;
293:217–228.
4. Preventive Foot Care in Diabetes. American Diabetes Association. Position Statement. Diabetes
Care, Volume 27, supplement1, January 2004.
5. Comprehensive Foot Examination and Risk Assessment report of the Task Force of the Foot Care
Interest Group of the American Diabetes Association, with endorsement by the American
Association of Clinical Endocrinologists. Diabetes Care, Volume 31, Number 8, p-1679- 1685
August 2008.
6. King LB. Impact of a preventive program on amputation rates in the diabetic population. J
Wound Ostomy Continence Nurs.2008 Sep-Oct;35(5):479-82;
7. Malone JM, Snyder M, Anderson G Bernhard VM, Holloway G Jr Bunt TJ. Prevention of
amputation by diabetic education. Am J Surg. 1989 Dec; 158(6):520-3.
8. Abdullah M Al-Wahbi. Impact of a diabetic foot care education program on lower limb
amputation rate Vascular Health and Risk Management 2010:6 923–934.
The Current status of foot-self-care education and
knowledge is unsatisfactory. A national diabetes
control program is urgently needed where a
structured foot self-care counseling and education
program is implemented and monitored, through
which a unified evidence-based information is
delivered by health care providers and the media,
aiming at prevention of limb loss among patients
with diabetes mellitus.
References:
Conclusions:
5