title: Diabetic Foot Disease, Self-Care and Clinical Monitoring in Adults with Type 2 Diabetes: The Alberta's Caring for Diabetes (ABCD) Cohort Study.
abstract: OBJECTIVE
  To examine the prevalence and predictors of foot disease, self-care and clinical monitoring in adults with type 2 diabetes in Alberta, Canada.
  
  
  METHODS
  Baseline data from a prospective cohort of adults with type 2 diabetes were used. Assessment of foot disease included self-reported peripheral neuropathy, peripheral vasculopathy, foot or leg ulcer/infection or gangrene/amputation. Foot self-care was assessed using the Summary of Diabetes Self-Care Activities, and clinical monitoring using patients' reports of having feet checked for lesions or sensory loss.
  
  
  RESULTS
  The mean age of respondents (N=2040) was 64 (SD 10.7) years; 45% were female, and 91% were Caucasian. Peripheral neuropathy was reported by 18% of the respondents, peripheral vasculopathy by 28%, ulcer/infection by 6% and gangrene/amputation by 1.4%. Only 14% of respondents performed foot self-care behaviours ≥6 days per week, and only 41% and 34% had their feet clinically checked for lesions or sensory loss, respectively. Predictors of foot disease included longer duration of diabetes, smoking, depressive symptoms, low self-efficacy and a history of cardiovascular diseases. Predictors of good self-care included older age, female sex, longer duration of diabetes and no report of hyperlipidemia. Predictors of clinical monitoring included female sex, current smoking, residing in urban areas, longer duration of diabetes, and histories of heart disease or hyperlipidemia.
  
  
  CONCLUSIONS
  Peripheral neuropathy and vasculopathy were the most common reported foot problems in this population. Foot self-care is generally infrequent, and clinical monitoring is performed for less than half of these patients, with significant variations by patient demographics and clinical presentation.
authors.affiliation: Alliance for Canadian Health Outcomes Research in Diabetes, School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Fatima
authors.initials: F
authors.lastname: Al Sayah
authors.affiliation: Alliance for Canadian Health Outcomes Research in Diabetes, School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Allison
authors.initials: A
authors.lastname: Soprovich
authors.affiliation: Alliance for Canadian Health Outcomes Research in Diabetes, School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Weiyu
authors.initials: W
authors.lastname: Qiu
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Alun L
authors.initials: AL
authors.lastname: Edwards
authors.affiliation: Alliance for Canadian Health Outcomes Research in Diabetes, School of Public Health, University of Alberta, Edmonton, Alberta, Canada. Electronic address: jeff.johnson@ualberta.ca.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Johnson
mesh_terms: D000368:Aged; D000416:Alberta / Q000453:epidemiology; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D017719:Diabetic Foot / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012648:Self Care / Q000379:methods*
keywords: auto-prise en charge; diabète de type 2; examen du pied; foot disease; foot exam; pied diabétique; self-care; type 2 diabetes