Foot care among diabetic patients in south Auckland

To describe footcare among diabetic patients in south Auckland.

Direct interview of 331 European, 86 Maori and 123 Pacific Islands patients attending local diabetes services and a stratified subsample of general practitioners. Interviews included closed and open questions of diabetes knowledge, demographic and medical history and were followed by a thorough inspection of the feet.

Major lesions (amputation, foot ulcer) and predisposing lesions (callus or fungal infection/maceration) were present in 48.5% of patients. Major lesions were particularly common among Pacific Islands patients (9.4%) vs European (3.9%), Maori (5.5%), (p < 0.05). Fungal infection/maceration was less common among Pacific Islands patients (23.0%) vs 42.3%, 42.2% respectively, (p < 0.001). Fungal infection/maceration was more common and callus formation less common among men when compared with women. Forty percent (n = 214) of patients, including eight with either an ulcer or a blister, had not had their feet examined over the preceding 12 months. Good foot care was present in 52.7% Europeans, 31.0% Maori and 26.8% Pacific Islands patients (p < 0.001). Diabetes knowledge was poorest in those with poor foot care among Europeans and Maori.

While the provision of footcare advice, adherence to such advice and monitoring of footcare remain uneven, the hospital and community costs of the diabetic foot will continue to be high.