title: A study of risk factors and foot care behavior among diabetics.
abstract: BACKGROUND
  Diabetic foot results in considerable morbidity and mortality in developing countries and the prevalence of diabetes is expected to increase further in the next decades in these countries. Diabetic ulcers are the most common foot injuries leading to lower extremity amputation. Family physicians have a pivotal role in the prevention or early diagnosis of diabetic foot complications. Patient education regarding foot hygiene, nail care and proper footwear is crucial to reducing the risk of an injury that can lead to ulcer formation.
  
  
  METHODS
  This is a prospective study carried out from July 2013 to September 2015. Fifty patients of Diabetes with foot ulcer and two hundred without foot ulcers were examined. Risk factors and clinical profile of patients were studied which included age, gender, duration of diabetes, BMI, smoking, random BSLs history, hypertension, glycated haemoglobin levels, lipid profile, history of loss of sensation and history of amputation. MNSI questionnaire and MNSI practical assessment for neuropathy were administered to diabetic patients along with a pre-structured questionnaire regarding foot care practices.
  
  
  RESULTS
  In this study significant risk factors were peripheral neuropathy, peripheral vascular disease, gender, loss of sensation, duration of diabetes and smoking. MNSI questionnaire and practical assessment scores were higher in foot ulcer patients. Poor foot care practices were observed in patients with diabetic foot ulcer patients.
  
  
  CONCLUSIONS
  Diabetic foot ulcers were more common in elderly males. Peripheral neuropathy, peripheral vascular disease, Smoking, trauma, duration of diabetes mellitus and high levels of glycated haemoglobin had significant association with occurrence of foot ulcers. MNSI scores had a high predictive value for development of foot ulcers amongst diabetics. Awareness regarding foot care was poor which underlines need to promote practice of foot care amongst diabetic population.
authors.affiliation: Department of Surgery, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India.
authors.forename: Mackson
authors.initials: M
authors.lastname: Nongmaithem
authors.affiliation: Department of Community Medicine, Army College of Medical Sciences, New Delhi, India.
authors.forename: Arjinder Pal Singh
authors.initials: AP
authors.lastname: Bawa
authors.affiliation: Department of Surgery, Military Hospital Kirkee, Armed Forces Medical College, Pune, Maharashtra, India.
authors.forename: Abhilash Kumar
authors.initials: AK
authors.lastname: Pithwa
authors.affiliation: Department of Surgery, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India.
authors.forename: Simran Kaur
authors.initials: SK
authors.lastname: Bhatia
authors.affiliation: Department of Surgery, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India.
authors.forename: Gurjit
authors.initials: G
authors.lastname: Singh
authors.affiliation: Department of Surgery, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India.
authors.forename: Somnath
authors.initials: S
authors.lastname: Gooptu
keywords: Diabetic foot; foot care; glycated hemoglobin