Knowledge and Practices of Foot Care among Patients with Diabetes Mellitus in the Asian Countries: A Systematic Review

Abstract

Background: Diabetes mellitus is the leading cause of non-traumatic amputation worldwide. The major amputation occurs every 20 seconds globally as a result of diabetic foot complications due to poor knowledge and practice of foot care. Objectives: To critically appraise evidence on the knowledge and practices of foot care among patients with type 2 diabetes mellitus in Asian countries. Methods: A systematic review was conducted to critically appraise and summarize the data into a single study. Thus, Pub Med, CINAHL and Wiley Online Library were referred using the keywords; type 2 diabetes mellitus, knowledge, practices, foot care and Asian countries. Then 1390 articles were found published from 2015-2021 in English. The PRISMA filtering technique was focused to select the best research. Finally, seven articles were selected considering inclusion and exclusion criteria. Results: Qualitative thematic analysis was applied, and three key themes emerged from the results. The first key theme is the deficiency of knowledge of foot care leading to diverse complications. Many patients did not have enough knowledge regarding the daily inspection of the foot, checking the temperature of water before washing feet, drying feet after washing. The second theme is that poor practices of diabetic foot care cause amputations. They followed many malpractices such as not trimming toenails straight across, not applying any moisturizer on the foot skin to avoid dryness. The third theme is that footwear avoids injuries. Many malpractices leading to foot injuries were identified relating to footwear such as not checking the inside before wearing shoes, wearing barefoot indoor and outdoor frequently. Conclusions: The deficiency of knowledge and malpractices of diabetic foot care are influential factors for the development of various foot complications as well as increasing foot amputations. Therefore, health care providers should maintain regular educational programs ensuring knowledge and practice.