Risk Assessment of Diabetic Foot Disease at Family Health Centers in Alexandria, Egypt

Abstract

Background: Diabetic foot is a costly complication of Diabetes Mellitus (DM). It significantly impacts public health, and society, necessitating empowering the crucial role of family physicians (FPs) in evaluating and managing diabetic foot. The objective was to estimate the rates of peripheral neuropathy (PN) and peripheral arterial disease (PAD) as well as assess the risk of diabetic foot disease (DFD) among diabetic patients at family health centers in Alexandria (Egypt) as well as assessing the practice of FPs regarding diabetic foot care. Methods: A cross-sectional study was conducted among 513 diabetic patients at eight family health centers/units (FHC/Us) in Alexandria. A clinical examination and pulse oximeter (PO) oxygen saturation measurement were performed to detect PN and PAD, respectively. DFD risk stratification was done based on the Egyptian diabetes practice guidelines. FPs’ practices were assessed through reviewing patients’ records using a predesigned checklist. Results: PN and distal symmetrical polyneuropathy (DSPN) were detected in 96.3% and 55.2% of patients, respectively. PAD was detected in 0.6% of patients. Approximately 27.3% of patients had high-risk diabetic foot. FPs considered 1.6% of patients as having high-risk foot. Approximately 79.5% of patients received no education about the care of diabetic foot. FPs performed partially regular foot checkups in 66.7% of patients at moderate and high-risk feet categories. Conclusions: The majority of diabetic patients had PN and subsequently were categorized as having moderate- to high-risk foot. FPs should regularly monitor DFD in accordance with the management plan for each foot risk category.