title: Diabetic foot disease and foot care in a Caribbean community.
abstract: We estimated the prevalence of foot symptoms and disease and evaluated foot care practices in a primary care based sample including 2106 people with diabetes in Trinidad. Symptoms of neuropathy were reported by 1030 (49%), previous foot ulceration by 257 (12%), and amputation by 92 (4%). Previous foot ulceration was associated with longer duration of diabetes (odds ratio 1.05, (95% CI 1.04-1.06) per year) and greater severity of neuropathy symptoms (1.17 (1.10-1.24) per unit increase in score). A history of foot ulceration gave relative odds of amputation of 16.3 (8.1-32.9). In those with previous foot ulceration, 120 (47%) went barefoot in the home, and 44 (17%) went barefoot outside the house. Overall, 1491 (71%) subjects reported they cut their toenails themselves, help was provided by a friend or relative to 584 (28%) and by a nurse or chiropodist to 13 ( < 1%). Most patients (1320, 63%) reported that they would treat a cut or blister on the foot themselves, while only 650 (31%) would attend for health care. Diabetic foot disease is common but care practices predispose to foot injury. Implementation of a strategy to improve care of the feet is needed.
authors.affiliation: Department of Public Health Sciences, King's College London, SE1 3QD, UK. martin.gulliford@kcl.ac.uk
authors.forename: Martin C
authors.initials: MC
authors.lastname: Gulliford
authors.forename: Deepak
authors.initials: D
authors.lastname: Mahabir
mesh_terms: D000671:Amputation, Surgical / Q000706:statistics & numerical data; D017719:Diabetic Foot / Q000453:epidemiology / Q000628:therapy*; D003929:Diabetic Neuropathies / Q000453:epidemiology; D005260:Female; D016523:Foot Ulcer / Q000453:epidemiology; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012008:Recurrence; D012648:Self Care; D014300:Trinidad and Tobago / Q000453:epidemiology