Evaluation of diabetic patients' knowledge about diabetic foot at Baghdad Teaching hospitals

Background: Diabetes mellitus is a metabolic disorder leading to high blood glucose levels, affecting approximately 451 million people globally and causing around 5 million deaths in 2017. Diabetic patients are at an increased risk of developing foot ulcers due to microvascular and neuropathic changes. Neuropathy decreases sensation in the feet, making them more susceptible to injuries, while microvascular issues restrict blood flow, hindering wound healing. Haemoglobin A1c (HbA1c) reflects average blood glucose levels over the past 2 to 3 months. The American Diabetes Association and the International Expert Committee recommend a level of 6.5% or higher for diagnosing diabetes. Moreover, for each 1% increase in HbA1c, the risk of developing peripheral vascular disease increases by 25% to 28%. Patients with diabetes are at risk for serious complications, such as lower extremity amputations, higher healthcare costs, and a diminished quality of life. A systematic review found that the 5-year mortality rate after below-the-knee amputations ranges from 40% to 82%, while it is even higher for above-the-knee amputations, ranging from 40% to 90%. Many of these complications can be prevented by having annual foot exams and ensuring proper foot care by patients [1].

Objective: The purpose of this study is to assess diabetic patients' knowledge at Baghdad's hospital about diabetic foot disease and to design community awareness campaigns focusing on the importance of diabetic foot treatment and prevention.

Methods: A cross-sectional study was conducted to assess the knowledge of diabetes mellitus complications, specifically foot ulceration, among 100 hospitalized patients and nurses at the teaching hospital in Baghdad. The questionnaire consisted of two sections: the first included nine demographic questions (age, gender, residence, marital status, education, employment, economic status, previous therapy history, and sources of knowledge), while the second contained 16 questions evaluating knowledge about diabetes. Data were collected through a self-reported questionnaire, and analyses were performed using SPSS version 24.

Results: The study revealed that 94% of participants had high awareness.

Conclusions: Most patients (94%) possess a moderate understanding of diabetic complications and how to care for diabetic foot.