Juma M Al-Kaabi1, Fatma Al Maskari2, Paul Cragg3, Bachar Afandi3, Abdul-Kader Souid4. 1. Department of Internal Medicine, College of Medicine and Health Sciences, UAE University , Al-Ain, United Arab Emirates. Electronic address: j.kaabi@uaeu.ac.ae. 2. Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates. 3. Diabetes Center, Tawam-John Hopkins Hospital, Al-Ain, United Arab Emirates. 4. Department of Pediatrics, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
Abstract
BACKGROUND: Diabetes is especially common in the United Arab Emirates. Its complications in patients residing in the region have yet to be fully explored. This study reports on foot problems in our diabetic patients, with emphasis on the impact of illiteracy on foot care and complications due to diabetes. METHODS: Adults were randomly recruited from the Diabetes Center at Tawam-John Hopkins affiliated hospital. A questionnaire addressing foot care and problems was completed for all patients. In addition, an examination was performed by a trained nurse, an endocrinologist, and a podiatrist. RESULTS: Four hundred twenty-two adults with type 2 (93%) or type 1 (7%) diabetes were enrolled; 67% were females. Patients' mean age was 52 ± 13 years and duration of diabetes ≥ 1 year. Illiterate patients were 51% and were less likely to practice foot care (p=0.002), recognize foot risk factors (p=0.004), use proper footwear (p=0.010), and being physically active (p<0.001). In addition, they were more likely to have diabetic complications, such as neuropathy (p=0.027), eye disease (p=0.032), hypertension (p<0.001), obesity (p=0.003), increased body fat percentage (p<0.001), reduced capillary refill time (p=0.002), reduced monofilament (p=0.003), and reduced vibration (p<0.001). Logistic regression analysis revealed literates [OR=2.4, CI=1.1-5.4, p=0.031], female gender [OR=2.7, CI=1.1-6.2, p=0.023], and history of foot ulcer [OR=6.0, CI=2.1-17.2, p=0.001] were predictors of practicing foot care. CONCLUSION: Illiteracy invoked significant challenges to diabetic attentiveness and imposed increased foot complications. Physicians should realize that illiterate patients are vulnerable and require effective strategies to improve their education about the disease and reduce their diabetic complications.
BACKGROUND:Diabetes is especially common in the United Arab Emirates. Its complications in patients residing in the region have yet to be fully explored. This study reports on foot problems in our diabeticpatients, with emphasis on the impact of illiteracy on foot care and complications due to diabetes. METHODS: Adults were randomly recruited from the Diabetes Center at Tawam-John Hopkins affiliated hospital. A questionnaire addressing foot care and problems was completed for all patients. In addition, an examination was performed by a trained nurse, an endocrinologist, and a podiatrist. RESULTS: Four hundred twenty-two adults with type 2 (93%) or type 1 (7%) diabetes were enrolled; 67% were females. Patients' mean age was 52 ± 13 years and duration of diabetes ≥ 1 year. Illiterate patients were 51% and were less likely to practice foot care (p=0.002), recognize foot risk factors (p=0.004), use proper footwear (p=0.010), and being physically active (p<0.001). In addition, they were more likely to have diabetic complications, such as neuropathy (p=0.027), eye disease (p=0.032), hypertension (p<0.001), obesity (p=0.003), increased body fat percentage (p<0.001), reduced capillary refill time (p=0.002), reduced monofilament (p=0.003), and reduced vibration (p<0.001). Logistic regression analysis revealed literates [OR=2.4, CI=1.1-5.4, p=0.031], female gender [OR=2.7, CI=1.1-6.2, p=0.023], and history of foot ulcer [OR=6.0, CI=2.1-17.2, p=0.001] were predictors of practicing foot care. CONCLUSION: Illiteracy invoked significant challenges to diabetic attentiveness and imposed increased foot complications. Physicians should realize that illiterate patients are vulnerable and require effective strategies to improve their education about the disease and reduce their diabetic complications.
Authors: Juma M Alkaabi; Fatima Al-Maskari; Bachar Afandi; Said Yousef; Syed M Shah; Wieke H Heideman; Emmanuel A Papadimitropoulos; Taoufik Zoubeidi; Abdul-Kader Souid; Marília Silva Paulo; Frank J Snoek Journal: Oman Med J Date: 2021-05-31