Foot complications among diabetics attending a district hospital in Kenya: Predisposing factors and possible intervention

OBJECTIVES: To relate skin health, footwear practices and foot care education with occurrence of foot complications among diabetics attending a district hospital in Kenya. PATIENTS AND METHODS: Two hundred and nineteen patients attending the diabetic clinic at the Kikuyu Mission Hospital (99 males, 120 females) were studied. They were examined for the presence, type and cause of foot complication, skin health, education on foot care and footwear. RESULTS: Twenty nine point two percent of the patients had foot complications, with 95% of these presenting with diabetic ulcer, the rest had Charcot’s foot or cellulitis. The diabetic foot ulcer was traumatic in 75.4% and spontaneous in 24.6%. Fifty seven percent of the patients had risky footwear, associated with development of foot ulcer (p = 0.001). Ninety eight percent of the patients with foot complications had either atrophic or dry skin (p = 0.001). Fifty two point four percent had not received foot care education, with males who had received education being more than females (p = 0.05). CONCLUSION: The rate of foot complications among diabetics is higher than previously observed. Diabetic foot ulcer, the commonest complication, is mostly traumatic. Patients with foot care education, proper footwear and good skin health had lower incidence of traumatic diabetic foot ulcer. Dissemination of foot care education and use of right footwear for diabetics may reduce the incidence of complications