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Today's podiatrist has the necessary education and training to treat all conditions of the foot and ankle and plays a key role in keeping America healthy and mobile while helping combat diabetes and other chronic diseases. Your feet are excellent barometers for your overall health.

Healthy feet keep you moving and active. They are quite literally your foundation. In this section, learn more about APMA Seal-approved and accepted products, proper foot care, common foot and ankle conditions, and how your podiatrist can help keep you and your feet healthy. APMA is the only organization lobbying for podiatrists and their patients on Capitol Hill.

As the voice of podiatric medicine to your legislators and regulators, APMA is active on a variety of critical issues affecting podiatry and the entire health-care system. Diabetes can have a significant impact on your feet, so seeing a podiatrist at least once a year is an important part of managing your condition and preventing complications.

If you do experience a problem with your feet, your podiatrist is the best-qualified physician to treat it. When you add a podiatrist to your health-care team, he or she can provide you with important information so you're better able to manage the effects of diabetes on your feet.

If you are looking for a podiatrist in your area, check out our Find a Podiatrist tool. Whether you've been diagnosed recently or have been fighting the disease for years, the resources below will help you to monitor your feet and prevent complications.

Individual members and practices can make use of the following resources to promote their expertise and educate current and prospective patients.

Note: Members in New York should contact NYSPMA Executive Director Dan Kline for materials customized for your needs. Diabetes Awareness. Press Room. APMA Buyers' Guide. User Agreement. Privacy Policy. Search Login Join. About APMA Career Center News Events Benefits Industry Find a Podiatrist.

Learn More. A Career in Podiatry Student Resources Resident Resources. Prepare for Your Appointment Conditions Affecting the Foot and Ankle Tips for Healthy Feet Foot Health Awareness Month Diabetes Awareness.

For Patients An Overview: What is diabetes? What is peripheral arterial disease? What is peripheral neuropathy? What is a diabetic foot ulcer? How Diabetes Affects Your Health: Watch this short video to learn how diabetes can affect your overall health.

Diabetes Footwear and Products: View our podiatrist-approved products for managing and treating diabetes. Outsmarting Diabetes: Take a look at this suite of videos that highlights how today's podiatrists are developing and using smart medicine to help their patients with diabetes.

In the current study, having one or two more complications was considered a positive condition. A total of out of distributed questionnaires were completed and returned; the response rate was A three-section questionnaire was used in the current study.

First section included demographic characteristics such as age, gender, and duration of diabetes mellitus, place of residence, occupation, and level of education, marital status, and body mass index. The questionnaire was used to measure the level of knowledge and practice of subjects toward diabetic foot care.

The total score for each part ranged 0 to The questionnaire was translated into the Persian language. Following the translations conducted by an Iranian professor of English literature, a native bilingual English speaker translated it back into English.

Content validity was determined by gathering the views of 15 medical and nursing professionals after reviewing the questionnaire. Content validity ratio CVR and content validity index CVI of the questionnaire were assessed. Mean scores of CVI and CVR were higher than 0.

In order to assess the differences between groups, the Wilcoxon, Mann-Whitney, and Kruskal-Willis tests were used for continuous variables. Factors related to knowledge and practice was estimated by multiple regressions. In order to assess the relationship between individual variables with knowledge and practice, we had to integrate these two items in order to have a better analysis.

All analyses were performed using SPSS version The mean ± SD age of the participants was In terms of knowledge, only 57 participants In terms of practice, only 33 patients 8. There was a significant relationship between knowledge score and gender, duration of diabetes, occupation, level of education, place of residence, having DFU, hospital stay history, and amputation history.

In the current study, majority of patients with diabetes had lower levels of education. Studies report that level of knowledge depends on the level of education [ 14 , 19 ]. Understanding this variable is highly important in designing strategies to prevent diabetes. A study conducted on patients with diabetes in Western Nepal reported poor KAP knowledge, attitude and practices score; they indicated that the plausible factors could be lack of knowledge, lack of information, and literacy level of the studied population [ 21 ].

Another study on young Saudi females with diabetes also reported poor KAP scores [ 19 ]. Some studies reported that patients with diabetes had good level of knowledge about diabetes [ 7 , 16 , 22 , 23 ].

The differences in knowledge about foot care among patients with diabetes across the studies could be due to different trainings on diabetes care provided by the health care professionals in different settings [ 23 ] and also the literacy level of the studied subjects.

Several studies reported poor foot care practices among patients with diabetes. Kheir et al. Hamidah et al. Desalu et al. It was difficult to compare the results of the current study with those of other studies since the nature of the study populations and the applied measurements were different.

In the current study, there was a direct and significant correlation between knowledge and practice scores; therefore, with an increase in the knowledge score, the practice score also increased. Other studies also showed that patients who receive trainings on foot care checked their feet regularly [ 20 ].

Patients who are advised to take care of their feet and the ones whose feet are regularly checked by physicians have better practices toward foot care [ 27 ].

In the current study, the lowest knowledge scores were regarding the application of talcum powder or other powders and not using lotions between the toes, and the proper way of trimming the toenails; while the lowest practice scores were related to the application of talcum powder between the toes, the proper way of trimming the toenails; keeping the foot skin soft, and avoid dryness.

It should also be noted that due to wet climate in the North of Iran, use of lotion between the toes is not common. Nevertheless, it also needs training. Patients with diabetes need to keep between their toes dry using talcum powder and avoid the application of lotion since it is important as a hygienic measure for feet in preventing fungal infection [ 28 ].

Patients should also use skin moisturizers daily to keep the skin of their feet soft and should trim their toenails straight across not rounded to prevent damage to their toes [ 29 ].

In the current study, gender, duration of disease, occupation, place of residence, level of education, having DFU, and a history of hospitalization, amputation, and complication had significant relationships with knowledge.

Also, gender, duration of disease, place of residence, occupation, and level of education had significant relationships with practice. The current study results showed that males were usually reluctant to disclose their health problems and seek professional care.

Also, males presented greater deficit in self-care compared to females [ 30 ]. In the study by Muhammad-Lotfi, age, gender, level of education, and duration of diabetes had no significant relationship with knowledge and practice.

This finding was in agreement with that of the current study [ 16 ], but another study indicated a significant relationship between the level of education and knowledge [ 31 ]. People with higher education are expected to be more likely to read and receive information about their illness and foot care and understand the information provided by medical staff in health care settings.

But in the current study, there was no significant relationship between the level of education and knowledge or practice, which could be due to the poor and inadequate resources of information about diabetes at the community level, since both educated and uneducated groups had inadequate information.

It may also be due to the fact that in spite of possessing knowledge, due to the lack of time, heavy work load, and lack of adequate insurance coverage, patients could not take good care of their feet in practice, which requires more studies to root out the causes.

Nevertheless, the attitude of patients toward self-care in addition to sufficient knowledge was not studied in the current study. As observed in the present study, patients with a history of DFU or hospital stay, and even amputation and complication had higher knowledge level. It could be due to the fact that while completing the questionnaire, the current knowledge level of the subjects was questioned, which indicated that training medical centers can raise the level of knowledge in patients with DFU.

In many Iranian state hospitals, diabetic training programs are not well organized, and the existing programs are weak. It is believed that knowledge about diabetes in the general population as well as patients with diabetes in Iran is not enough and there is a dire need for a good program for diabetes [ 32 ].

The collected data indicated that patients with diabetes had poor practice and knowledge about foot care. This is basically due to lack of proper communication between patients and medical team and inadequate education. Therefore, adaptation, implementation, and evaluation of the educational programs were recommended [ 33 ].

Thus, patients should be trained for foot ulcer prevention based on clinical practice guidelines for diabetes mellitus both in the community and hospitals. The results of the current study encouraged a positive outlook: A diabetes educator should give necessary advices to patients during every visit, in order to improve their perception about disease, diet, and lifestyle changes and help them control their glycemic level and overcome the complications of diabetes.

Knowledge and practice toward foot care were poor in most patients with diabetes. There was a significant relationship between some demographic characteristics of patients and knowledge and practice toward foot care. The level of knowledge, place of residence, marital status, and history of hospital stay due to DFU were the predictors of practice in patients with diabetes.

The strength of the current study was that it was the first, study to discuss this important issue in Guilan Province. The study also had some limitations; first, since the work had a cross sectional design, the direction of relationships and causal relationships cannot be determined.

Second, the result of the study should be interpreted with caution, since they were obtained from a single center; a clinic-based study. Hospital-based studies cannot provide a true picture of knowledge and practice in the community.

The current study sample did not represent the whole Iranian population consisting of several ethnicities. Perhaps with increasing sample size, we could solve this problem in future studies.

Adequate knowledge and good practices are important to effectively control diabetes mellitus. Patients require continuous support of family members and community in order to modify their lifestyle and behaviors and make sustainable changes in order to better control their diabetes disease.

Also, education about diabetes mellitus and its risk factors should be provided through mass media in order to effectively control it in the community.

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