The role of appropriate footwear in the management of diabetic foot: Perspective of clinicians in a low resource setting

Abstract

The use of appropriate footwear among patients with diabetes mellitus and those with diabetic foot problems has been documented to play a vital role in the prevention and treatment of the established foot disease. However, there is a paucity of literature on the role of clinicians in ensuring appropriate footwear among patients with diabetes mellitus. This paper explores current practice in the use of appropriate footwear in patients with diabetes mellitus among clinicians in Kaduna state, Nigeria. A self-administered structured questionnaire was developed. The questionnaire was divided into two sections: demographic (clinical area of specialization, number of years in practice) and footwear questionnaire. The footwear questionnaire focused on three themes: diabetic foot problems encountered, type of footwear worn, and the role of footwear in the prevention of diabetic foot complications. Data were processed and analyzed using Microsoft Excel 2007. Almost all the participants, 41 (91%), reported that foot ulcers could be related to inappropriate footwear. Most participants, 37 (82%), reported that ill-fitting footwear could be a major problem that leads to amputation. The shoe type reported to be most frequently worn by men were sandals (35%), slippers (26%), and half shoes (17%). The three commonest shoe types that women were reported to wear were slippers (45%), sandals (24%), and half shoes (18%). This study shows that the use of appropriate footwear in the prevention of diabetic foot complications is suboptimal. It is important that healthcare professionals support and stimulate research in establishing a diabetic footwear program.