Diabetic Foot Care: Knowledge and Practices among Diabetic Patients at a Teaching Hospital in Lahore Pakistan

Abstract

Background: Diabetic foot ulcers affect 19–34% of diabetic patients and significantly impair quality of life through pain, limited mobility, work loss and reduced social functioning in addition to limb amputation. Despite need for preventive care, poor awareness among patients and lack of routine foot examination contribute to worsened outcomes.

Objective: To assess the knowledge and practices related to diabetic foot care among diabetic patients.

Methods: This cross-sectional study was conducted at Department of Medicine, Chaudhary Muhammad Akram Teaching and Research Hospital, from April to July 2025. After ethical approval and informed consent, 155 diabetic patients, of both genders, were enrolled using non-probability consecutive sampling technique. Patients with history of foot or limb surgery, amputation, gangrene, steroid use, malignancy, pregnancy or postpartum, or pre-existing psychiatric disorders were excluded. Diabetes mellitus was defined as HbA1c ≥6.5%, or two random blood glucose readings ≥200 mg/dL, or a documented history of diabetes or use of anti-diabetic medications. After collecting demographic data, a structured questionnaire adapted from previously published literature was used: the knowledge domain comprised 12 true/false questions; the practice domain included 8 questions rated on a 3-point Likert scale: never, sometimes and always.

Results: Mean knowledge score was 7.8±2.4 while mean practices score was 9.3±2.7. One-way ANOVA revealed that none of the patient variables were significantly associated with knowledge scores. However, family income (p=0.038) and ischemic heart disease (p=0.018) showed statistical associations with practice scores. Spearman’s rank correlation revealed a positive association between knowledge and practice scores (ρ=0.691, p<0.001).

Conclusions: Although most patients had good knowledge about foot care, optimal practices were deficient. To improve foot care behaviors, patient education and tailored interventions should be undertaken to decrease risk of foot ulcers.