Compliance With Foot Care Practices Among Patients With Diabetes Mellitus in Sudan

Diabetes Mellitus (DM) is frequently complicated by Diabetic Foot Ulcers (DFUs), which contribute to high morbidity, mortality, and healthcare costs. Regular foot care and clinic follow-up can reduce the incidence of DFUs and related complications, yet adherence to these practices remains poorly described in Sudan. To assess compliance with foot care practices and identify factors associated with compliance and barriers to regular foot care clinic attendance among patients with diabetes attending the Jabber Abo Aliz Diabetes Care Center in Khartoum, Sudan. A cross-sectional descriptive study was conducted from December 2021 to February 2022 involving 120 patients with DM attending foot care clinics. Data were collected using structured questionnaires covering demographic and clinical characteristics, foot care behaviours, and perceived barriers. Compliance was measured using a Likert-based scoring system, with scores ≥ 9/17 classified as compliant. Data were analysed using SPSS version 21.0, applying Chi-square tests and ANOVA where appropriate, with statistical significance set at p < 0.05. Among 120 participants (55% female; mean age 49 ± 11 years), 70% were classified as compliant with foot care. Compliance was significantly associated with female gender (p = 0.043), age < 40 years (p = 0.034), urban residence (p = 0.037), higher socioeconomic status (p = 0.002), and good glycemic control (HbA1c ≤ 7%; p = 0.001). Duration of DM showed no significant association (p = 0.184). Transportation and distance were the most reported barriers to clinic attendance (30%). Most patients attending foot care clinics demonstrated good adherence to foot care practices, particularly those with favourable socioeconomic and clinical profiles. However, geographic and economic barriers continue to limit regular attendance. Strengthening outreach strategies, reducing access barriers, and integrating foot care education into routine diabetes management could improve outcomes and reduce DFU-related complications in Sudan.