Barriers Affecting Diabetic Foot Care in Primary Healthcare Settings in Al-Ahsa, Saudi Arabia

Diabetes mellitus is a metabolic disease characterized by hyperglycemia, leading to long-term organ damage and complications like foot ulcers. Aggressive management of diabetic foot ulcers can prevent complications and lower extremity amputations. This study aimed to assess the barriers faced by physicians in managing diabetic feet in primary care settings.

This is a descriptive cross-sectional study conducted in primary healthcare settings in Al-Ahsa, Saudi Arabia, between 2024 and 2025, involving 220 participants through simple random sampling. The study used a structured, valid, pretested, and self-administered questionnaire to collect data. The Statistical Package for the Social Sciences (SPSS) version 27 (Armonk, NY: IBM Corp.) was used to analyze the data. Both descriptive and inferential statistics were used, with a p≤0.05 considered statistically significant.

This study included 220 physicians (mean age: 32.14±6.05 years, 53.6% male), 130 (59.0%) had practiced for less than five years, 97 (44.1%) reported less than five continuing medical education (CME) hours related to diabetes, and 132 (60.0%) reported no special training in diabetes mellitus (DM). A majority of them, 160 (72.7%), rated their knowledge as average; 197 (89.5%) reported educating patients on preventive foot care, and 189 (85.9%) reported recommending therapeutic footwear. Only 102 (46.4%) probe for bone exposure in open diabetic foot (DF) infections, and 93 (42.3%) request serial radiographs. More than half identified a lack of continuing education and knowledge as the main barriers to the effective diagnosis and management of diabetic foot infections. Further barriers reported by participants were the absence of a vascular medicine specialty and a lack of diabetic foot management guidelines. Furthermore, 140 (63.6%) reported a lack of access to foot examination tools, and 152 (69.1%) reported insufficient time for comprehensive foot examinations.

This study highlights significant gaps in knowledge, practice, and resources among healthcare professionals involved in diabetic foot management. The findings demonstrate the need for targeted interventions in Al-Ahsa to improve clinician competency, enhance resource availability, and address systemic challenges.