title: Foot care practice - the key to prevent diabetic foot ulcers in India.
abstract: BACKGROUND
  The magnitude of diabetic foot ulcers (DFUs) and the amputation rates due to DFUs remain high even in developing and developed countries. Yet, the influence of knowledge, attitude, and practice (KAP) of diabetic foot care (DFC) on DFU incidence is not studied much.
  
  
  OBJECTIVE
  To study causal relationship between knowledge, attitude and practice (KAP) on DFC between diabetic patients with and without DFUs; and the risk factors associated with DFUs.
  
  
  METHODS
  A consecutive of 203 diabetic patients (103 with DFU and 100 without DFU) were included in the study. Their demographic details, medical history, and personal habits were recorded. KAP on DFC was assessed using a questionnaire. Responses were recorded, scored, and analyzed.
  
  
  RESULTS
  Of the cohort, 67.5% were males, mean age: 59.9 ± 11.4 years. Patients without DFU had good knowledge on DFC compared to those with DFU (86% versus 69.9%) (p<0.001). Incidence of DFU was 9% and 39.8% (p<0.001) among patients who practiced and not practiced DFC respectively. 88% patients with and without DFUs; showed favorable attitude toward adopting DFC. Risk factors - diabetic peripheral neuropathy, peripheral vascular disease, retinopathy, nephropathy, smoking, tobacco chewing and alcohol consumption were significantly (p<0.001) associated with DFUs.
  
  
  CONCLUSIONS
  An inverse relationship between DFU and foot care knowledge as well as practice was observed. Apart from tight glycemic control, diabetic patients must be educated and motivated on proper foot care practice and life style modifications for preventing DFUs.
authors.affiliation: Department of Endocrinology, Diabetes and Podiatric Surgery, School of Medicine, Amrita Institute of Medical Sciences and Research Center, Kerala, India. drgopic@gmail.com
authors.forename: Gopi
authors.initials: G
authors.lastname: Chellan
authors.forename: Soumya
authors.initials: S
authors.lastname: Srikumar
authors.forename: Ajit Kumar
authors.initials: AK
authors.lastname: Varma
authors.forename: T S
authors.initials: TS
authors.lastname: Mangalanandan
authors.forename: K R
authors.initials: KR
authors.lastname: Sundaram
authors.forename: R V
authors.initials: RV
authors.lastname: Jayakumar
authors.forename: Arun
authors.initials: A
authors.lastname: Bal
authors.forename: Harish
authors.initials: H
authors.lastname: Kumar
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology; D017719:Diabetic Foot / Q000453:epidemiology / Q000517:prevention & control*; D003928:Diabetic Nephropathies / Q000453:epidemiology; D003929:Diabetic Neuropathies / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000453:epidemiology; D012307:Risk Factors; D012648:Self Care; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014030:Tobacco, Smokeless