Knowledge, attitudes, and practices of Footcare in Diabetic patients in Hammoud University Medical Center

Knowledge, attitudes, and practices of Footcare in Diabetic patients in Hammoud University Medical Center | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Knowledge, attitudes, and practices of Footcare in Diabetic patients in Hammoud University Medical Center Reem Al Makari, Lynn Saifeddine, Nadia Al Masri, Hassan Balhas, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4165910/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction and literature: Diabetes mellitus is a metabolic heterogeneous disease that requires long-term management and is accompanied by several complications. Diabetic foot is one of the important complications encountered by diabetes. it arises to multiple vascular and neurological complications that diabetes results in. Patients need to be advised and follow the physicians' instructions to maintain the best outcomes. our study aims to tackle the knowledge, attitudes, and practices of diabetics regarding diabetic foot care at Hamoud Unversity Medical Center. Methods: a total of 108 patients in Hamoud University Medical Center were questioned after obtaining the hospital IRB approval. Results were entered and analyzed by Spss v23. quantitative data were analyzed as means and qualitative as frequencies and percentages. The scores were calculated into means, ANOVA, and t-tests were used to find correlations between scores and factors with significant p-values <0.05. Results: The study included 108 participants of mean age was 60.14 ±15.3. The majority of participants are males 64.8% ( n=70), and 34.3% (n=37) are of university level. out of diabetic complications, most are hypertensive. Patients were found to have good knowledge responses, some were with positive attitudes, and all were with bad practices. As for correlations, no statistically significant result was found in the knowledge section. Several factors were found with a positive relation in the attitude section as level of education and type of occupation. Lastly, also positive correlations were found in practices between several factors as duration of diabetes, occupation, and marital status with p-values <0.05. Conclusion: The study concludes that there is much more to learn and educate. Participants are aware of the dangers but do not follow proper health care services to prevent complications. Overall, the integration of both data sets reveals a multifaceted perspective among respondents, emphasizing the importance of tailored education, support, and interventions to promote adherence to foot care routines and optimize diabetes management outcomes. Diabetic Footcare Ulcer Lebanon knowledge Attitude Practices Background Diabetes mellitus and its complications Diabetes mellitus is a metabolic heterogeneous disease characterized with episodes of hyperglycemia and glucose intolerance, due to deficiency in insulin or lack in insulin action or both ( 1 ). Diabetes is a chronic disease that requires continuous strict monitoring of the glycemic levels to prevent short term and long-term complications. Awareness and patient education about the importance of regular exercise, weight loss, healthy diet and controlling blood sugar plays an important role in preventing acute complications and reducing long term complications ( 2 ).Despite healthy lifestyle and precautious measures, the longer you have diabetes and the lower your control to glycemic level the higher the incidence to have complication. Diabetes can cause both acute and chronic complications ( 5 ). Acute complications might manifest as diabetic ketoacidosis DKA, and hyperglycemic hyperosmolar state HHS, and lactic acidosis. However, chronic complications are further subdivided into micro and macro vascular complications, with retinopathy, nephropathy and neuropathy representing micro vascular complications ( 3 ) and cardiac, cerebral and vascular representing macro vascular complications. The most encountered micro vascular complications are diabetic retinopathy and nephropathy, manifesting as visual impairment or even blindness and chronic kidney disease respectively( 6 ). Additionally, peripheral neuropathy was highly prevalent complication in both type 1 diabetes (T1D) and type 2 diabetes (T2D), with a prevalence exceeding 50% in type 2 who are diabetic for more than 10 years ( 9 )( 4 )( 5 )( 6 ). Foot ulcers in diabetic patients As healthcare workers control outside consultation room is limited ( 7 ). Amongst the wide range of complications that accompany diabetes mellitus, diabetic foot infections stand out as one of the most challenging. Almost all patients with DM are at risk of developing diabetic foot infections with current studies showing that the prevalence of developing foot ulcers is 4–10%, the annual population based incidence is 1.0–4.1% and the lifetime incidence my reach as high as 25%( 12 ). Infections in ulcerated feet in patients with DM pose a major cause for morbidity in those patients, in addition to discomfort, increased number of visits to health-care providers, wound care and antimicrobial therapy ( 13 ). With infections being the most common cause (more than 50%), patients with DFIs frequently require minor or major amputations of the lower limbs ( 15–27%)( 14 ). Major amputations are associated with significant morbidity and mortality (ranging from 13 to 40% at 1 year to 39 to 80% at 5 years 2) in addition to psychological and financial consequences ( 15 ). It has been reported that nearly 70% of nontraumatic amputations were performed due to a diabetic foot( 10 ). Diabetic foot ulcer is defined as any necrosis, gangrene, or full-thickness skin defect occurring distal to the ankle in a diabetic patient( 3 ).Many reports showed that this problem is the most frequent cause of hospitalization for diabetic patients, representing up to 25% of all hospital admissions of diabetic patients.( 10 ) Knowledge, attitude, and practices about foot care in diabetic patients Diabetic foot care is extremely important for patients and their health( 10 ). They should be well educated about their disease and the complications caused. For instance diabetic patients should have received education about the sensation loss and decrease blood flow they will have with time( 11 ). These patients should also be aware of checking their sole of the feet and any developing ulcer due to delayed wound healing( 10 ). Many patients have deficit about the knowledge of these practices and that’s why it is very important to address these specific deficits in order to improve overall diabetic foot care.This point was revealed by Shamim et al.'s research in Alkharj , Saudi Arabia, which investigates the knowledge, attitudes, and practices regarding diabetic foot care among both Saudi and non-Saudi diabetic patients. The study provides valuable insights into the diverse population and their approach to foot care.It sheds light on the difference of approach to diabetic foot care in relation to different geographical and cultural context ( 19 ). The Saudi study mentioned that > 70% of the participants are well educated about diabetic foot care and how to deal with it ( 10 ). It was also seen that in another study in Riyadh confirmed that Saudian’s have good knowledge about the topic ( 11 ). Questions like the blood flow to the feet, the awareness of developing ulcers, and the loss of sensation in diabetic patients were asked in both studies ( 10 , 11 ). Another study done in Pakistan showed that nurses do educate patients about diabetic foot care for prevention rather than reaching ulcers and having to treat ( 16 ). Unlike rural parts of India where studies have found poor knowledge of diabetic foot care ( 17 ). Even though researches found good knowledge about diabetes and its complication the attitudes and practices are still poor. Performing a good attitude and practice includes clinical visits to the doctor, proper medication use, and proper treatment of sores ( 10 ). Fortunately the source of knowledge in major studies was from physicians and nurses ( 10 , 16 , 17 ). Shaqran et al revealed that participants perform regular exercises, take their medications properly, and take advices from specialist which indicates good attitudes ( 10 ). Practice levels in a study conducted by Alharbi et al. were average of 56% with performing good foot care as washing daily ,applying moisturizers, drying them, and inspecting shoes before wearing daily ( 18 ). Also, it was proven that those with longer duration of diabetes had better practices than those with shorter duration ( 10 ). That’s exactly why diabetic patient foot care practice is extremely and crucially important for limb preservation to avoid amputation and the loss that varies from toes till whole foot amputation which was proved by The study by Hanley et al. that focuses on diabetic foot care practices among patients with foot complications and amputation in St. Kitts and Nevis ( 15 , 16 , 17 ). No single study was found in Lebanon to address the issue and upon this the following research was conducted. Saudi Arabia was the main country to address foot care in diabetic patients and we have adopted their question to conduct ours. This research draws attention to the critical aspects of foot care in preventing severe complications. Subjects (Material) and Methods Study design : a cross sectional study targeting diabetic patients in HUMC Study place: Hamoud University Medical Center Study population (inclusion criteria &exclusion criteria): All Diabetic patients admitted to HUMC Study period: Surveying and data collection will start directly after the IRB approval. One year is the estimated time to complete this study. Sampling (type &size): There will be no sampling carried out for the purpose of this study. Nevertheless, 108 diabetic patients are included. Participants are to be interviewed with no upper limit. The minimum sample size was calculated based on confidence level of 95%, margin of error of 5%, these measures were selected to ensure that enough power can be achieved to test different hypotheses through future further analysis of the results. Data collection procedures and tools: All research participants will be approached by the investigators whereby the aims of the study will be explained and consenting will take place. The investigators will interview diabetic patients with a questionnaire targeting the aim of the research. It will take 5–10 minutes only. Plan of data processing and analysis: Processing of data will include data entry that will be entered into a Microsoft Excel spreadsheet which will be designed specifically for this study resembling the paper forms (same order of questions…) to avoid data entry mistake. After that, data will be transferred into the Statistical Package of Social Science (IBM SPSS, version 23) which will be used for data cleaning, management, and analyses using built range checks with automatic error prompts. In addition, we will perform ascending/ descending order view of variables and descriptive histograms that will easily identify outliers. Descriptive analyses will be carried out by calculating the mean and standard deviation for continuous variables, and number and percent for categorical ones. Knowledge, attitudes, and practices are analyzed as mean scores and compared using ANOVA and t-tests with the provided factors. Results The study included 108 participants of mean age was 60.14 ± 15.3. The majority of participants are males 64.8% ( n = 70), 34.3% (n = 37) are of university level, 27.8% (n = 30) are of high school level, and 11% (n = 12) are with no education level. Almost half of the participants 51.9% (n = 56) are employed and 66.7% (n = 72) are married. 75.9% (n = 82) of the participants are Lebanese and 56.5% (n = 61) are smokers. As for diabetic complications and other comorbidities, 78.7% (n = 85) are hypertensive, 31.5% (n = 34) are with renal disease, 58.3% (n = 63) are with dyslipidemia ,39.8% (n = 43) are with heart disease, and 23.1% (n = 25) suffer of retinopathy (Table 1 ). Table 1 Participants' Demographics Demographics Mean SD Age 60.14 ± 15.3 Frequency (n) Percentage % Gender Male 70 64.8% Female 38 35.2% Marital Status Single 18 16.7% Married 72 66.7% Widowed 16 14.8% Divorced 2 1.9% Education No Education 12 11.1% Elementary 6 5.6% Middle School 13 12% High School 30 27.8% University 37 34.3% Higher Education 10 9.3% Occupation Student 5 4.6% Employed 56 51.9% Unemployed 29 26.9% Retired 18 16.7% Nationality Lebanese 82 75.9% Palestinian 26 24.1% Smoker Yes 61 56.5% No 47 43.5% Hypertension Yes 85 78.7% No 23 21.3% Renal Disease Yes 34 31.5% No 74 68.5% Dyslipidemia Yes 63 58.3% No 45 41.7% Heart Disease Yes 43 39.8% No 65 60.2% Retinopathy Yes 25 23.1% No 83 76.9% In Table 2 , the majority of participants are with diabetes type 2 89.8% (n = 97). 68.5% (n = 74) had diabetes for more than 10 years and 37% (n = 40) were of uncontrolled Hba1c. The mean value of Hba1c was 7.7 ± 1.88. As for their medication 67.6% (n = 73) of the participants are on oral agents and only 4.6% (n = 5) are on diet only. 34.3% (n = 37) have current foot ulcers and 21.3% (n = 37) have reported multiple foot problems. 26.9% (n = 29) had amputation and 51.9% (n = 56) have received advice on diabetic foot care. Table 2 diabetes and its complications Diabetes and diabetic complications Frequency(n) Percentage % Diabetes type Type 1 11 10.2% Type2 97 89.8% Duration of Diabetes 10 Years 74 68.5% Last Reading of Hba1c Controlled 31 28.7% Uncontrolled 40 37% Highly Uncontrolled 6 5.6% Unknown 31 28.7% Diabetes Treatment Oral Agent (s)15 73 67.6% Insulin 15 13.9% Oral Agents and Insulin 15 13.9% Diet 5 4.6% Foot Complaints None 56 51.9% Current Ulcer 37 34.3% Healed Ulcer 15 13.9% Sensation problem in feet None 37 34.3% Foot Pain at rest 17 15.7% Multiple Problems 23 21.3% Foor Pain during walking 10 9.3% Numbness 21 19.4% Amputation Yes 29 26.9% No 79 73.1% Received advice on Diabetic foot Yes 56 51.9% No 52 48.1% Value of Hba1c Mean SD 7.77 ± 1.88 As for the knowledge section, participants answered 11 questions. 92.6% (n = 100) knew that diabetics develop foot ulcers, 92.6% (n = 100) knew that diabetics develop reduced blood flow in their feet, 97.2% (n = 105) knew that taking medications regularly reduces diabetic complications and 93.5% (n = 101) knew that it is important to examine foot ware for any tear or object ( Table 3 ) Table 3 Knowledge Knowledge Frequency (n) Percentage % Diabetics develops foot ulcers Yes 100 92.6% No 8 7.4% Diabetics develops reduced blood flow in their feet Yes 99 91.7% No 9 8.3% Diabetics develops reduced sensation in their feet Yes 100 92.6% No 8 7.4% Poor circulation develops from smoking Yes 100 92.6% No 8 7.4% Important to examine sole because diabetics develop poor sensation Yes 101 93.5% No 7 6.5% Wounds and infections do not heal quickly Yes 103 95.4% No 5 4.6% Taking medication regularly reduce DM complications Yes 105 97.2% No 3 2.8% It is important to examine foot ware for any tear or object Yes 101 93.5% No 7 6.5% Foot gangrene is one complication of DM foot infection Yes 101 93.5% No 7 6.5% Do you think exercise will help reduce complications Yes 96 88.9% No 12 11.1% Uncontrolled diabetes leads to foot deformity Yes 100 92.6% No 8 7.4% Table 4 demonstrates the attitude of participants for diabetic foot care. 58.3% (n = 63) said that they can take responsibility of daily examination of their feet and foot ware. 69.4% (n = 75) are able to live normal life with appropriate measures of diabetes and 68.5% (n = 74) can use special foot ware advised by foot-care specialist. Table 4 Attitude Attitude Frequency (n) Percentage % Can you perform regular exercise and change your food habits to prevent further diabetic complications? Yes 60 55.6% No 48 44.4% Can you take the responsibility of daily examination of your feet and foot ware, as well as regular footcare specialist consultation? Yes 63 58.3% No 45 41.7% Can you use special foot ware adviced by foot-care specialist? Yes 74 68.5% No 34 31.5% Will you wear footwear indoors as advised by your foot-care specialist? Yes 70 64.8% No 38 35.2% Can you be able to live a normal life with appropriate measures for diabetes? Yes 75 69.4% No 33 30.6% Table 5 reveals the practices of diabetic foot care among the participants. Half of the participants claimed that they used comfortable, closed, and soft foot ware and examined their shoes before wearing them whereas the other half did not. Only 33.3% (n = 36) said that they continuously wear cotton socks, and 32.4% (n = 35) said that regularly visit physicians for foot checkups. 42.6% (n = 46) only claimed that they wash their feet and dry in between the toes daily and regularly. 55.6% (n = 60) of the participants regularly cut their toenails. Table 5 Practices Practices Frequency (n) Percentage % Do you examine your feet daily ? Yes 40 37% No 68 63% Do you use comfortable, closed, and soft foot wear? Yes 54 50% No 54 50% Do you examine your shoes before wearing them? Yes 54 50% No 54 50% Do you walk barefoot, outside? Yes 34 31.5% No 74 68.5% Do you continuously wear cotton socks? Yes 36 33.3% No 72 66.7% Do you examine your feet for any marks resulting from shoes/socks? Yes 54 50% No 54 50% Do you change your socks daily ? Yes 77 71.3% No 31 28.7% Do you daily wash your feet with warm water? Yes 46 42.6% No 62 57.4% Do you carefully dry the cleft between toes after washing? Yes 46 42.6% No 62 57.4% Do you apply moisturizer daily on your feet? Yes 44 40.7% No 64 59.3% Do you cut your toenails regularly? Yes 60 55.6% No 48 44.4% Do you regularly visit a physician for a foot check-up? Yes 35 32.4% No 73 67.6% Do you regularly change foot-wear even without damage? Yes 57 52.8% No 51 47.2% As for studying the relation between knowledge and different factors, Table 6 showed that none of the factors was significantly related to knowledge out of total score of 11. For example, the mean score of those between 18 and 49 was slightly higher than the other age group (score = 10.5/11) but p-value = 0.76. males and females were with almost equal mean score but p-value > 0.05. Also, it was shown that those with longer duration of diabetes scored higher than those with short term but with no significant value. In general, all mean values of the categories were higher than 9. Table 6 Knowledge Correlated to different factors Knowledge Score Mean /11 P-Value Age (Years) 18–49 10.5 0.764 50–64 10.07 > 64 10.26 Gender Male 10.1 0.381 Female 10.5 Marital Status Single 11 0.266 Married 9.94 Widowed 10.63 Divorced 11 Education No Education 10.58 0.138 Elementary 10.33 Middle School 8.62 High School 10.43 University 10.59 Higher Education 10 Occupation Student 11 0.498 Employed 10.35 Unemployed 10.31 Retired 9.55 Smoker Yes 10.26 0.91 No 10.21 Diabetes type Type 1 10.73 0.453 Type2 10.19 Duration of Diabetes 10 Years 10.47 Last Reading of Hba1c Controlled 10.48 0.201 Uncontrolled 9.65 Highly Uncontrolled 11 Unknown 10.61 As for the relation between attitude and variables, the results are demonstrated in Table 7 . It was significantly proven with p-value < 0.001 that those of age group 18–49 were of best attitude (4.25/5). In addition, those who are single had the best attitude 4.05/5 with p-value < 0.05. Education, occupation, type of diabetes, and diabetes duration were statistically significant with p-values < 0.05. smoking, control of Hba1c, and gender was not statistically significant. Table 7 atittude Correlated to different factors Attitude Score Mean /5 P-Value Age (Years) 18–49 4.25 64 2.21 Gender Male 3.17 0.969 Female 3.15 Marital Status Single 4.05 0.016 Married 3.18 Widowed 2.25 Divorced 2 Education No Education 1.83 0.01 Elementary 2.33 Middle School 2.69 High School 3.2 University 3.7 Higher Education 3.5 Occupation Student 4.4 < 0.001 Employed 3.75 Unemployed 2.76 Retired 1.67 Smoker Yes 3.34 0.228 No 2.94 Diabetes type Type 1 4.18 0.04 Type2 3.05 Duration of Diabetes < 10 Years 4 10 Years 2.78 Last Reading of Hba1c Controlled 3.74 0.68 Uncontrolled 2.9 Highly Uncontrolled 2 Unknown 3.16 In Table 8 , relations between practices of mean score out of 13 questions is shown. Gender did not differ in practices with both mean score like each other. Those single were more likely to perform proper practices than others with mean score 7.28/13 and p-value = 0.031. Those employed had the highest score 8 with statistically significant p- value 10 years were statistically proven to perform better practices with a statistically proven p-value 64 5.35 Gender Male 5.86 0.84 Female 5.97 Marital Status Single 7.28 0.031 Married 5.8 Widowed 5.31 Divorced 2 Education No Education 4.33 0.113 Elementary 4 Middle School 5.46 High School 6.2 University 6.43 Higher Education 6.6 Occupation Student 8 0.039 Employed 6.39 Unemployed 5.07 Retired 5.11 Smoker Yes 6.06 0.49 No 5.68 Diabetes type Type 1 7.09 0.144 Type2 5.76 Duration of Diabetes 10 Years 5.42 Last Reading of Hba1c Controlled 6.35 0.508 Uncontrolled 5.48 Highly Uncontrolled 6.83 Unknown 5.8 Discussion This study’s aim is to assess and highlight the knowledge, attitudes and practices of foot care among diabetic patients in Hammoud University Medical Center, Lebanon.In contrast to other previous studies which demonstrated that patients with a higher level of education possess a greater understanding of diabetic foot care( 11 , 1 , 2 ), the data from our study suggests that uneducated patients have similar knowledge of diabetic foot care in comparison to educated ones. Our study data also shows that single or divorced patients have greater knowledge than those who are married. This opposes to the idea of spousal support, in terms of nutrition, commitment, treatment and better coping with long term diseases, that comes with being married ( 3 ). patients who have had diabetes for > 10 showed more knowledge similarly to a study in Saudi Arabia ( 18 ). As mentioned in that study, this could be due to the patient’s long-term exposure to the disease which lead to more experience and better handling in term of diabetic foot care. A significant majority of respondents (92.6%) recognize the high likelihood of diabetics developing foot ulcers, reduced blood flow, and reduced sensation in their feet, indicating a robust awareness of the significant risks associated with diabetes-related foot complications just like Alshammari et al.that found that a majority of diabetic patients recognized the risks associated with foot complication similar to the high awareness observed in our study ( 18 ). Additionally, while 97.2% believe that regular medication intake can reduce diabetes complications, there remains a need to address skepticism regarding exercise, with 88.9% acknowledging its potential benefits, and 11.1% expressing doubts.Moreover, the skepticism towards exercise reported in our data echoes findings by Taksande et al., indicating a common trend in addressing lifestyle modifications among diabetic individuals ( 17 ) Respondents' willingness to engage in preventive measures and lifestyle modifications reflects a proactive stance towards self-care. Notably, 55.6% express confidence in their ability to incorporate regular exercise and dietary changes to prevent further diabetic complications. However, a significant portion (44.4%) appears uncertain or hesitant, suggesting potential barriers or misconceptions hindering adherence to lifestyle modifications. Furthermore, a majority (58.3%) are willing to take responsibility for daily foot examinations, foot ware maintenance, and regular consultations with foot-care specialists,in contrast a notable proportion (41.7%) express hesitation or reluctance, indicating challenges in implementing consistent foot care routines. Nonetheless, the majority (68.5%) are open to using specialized foot ware recommended by foot-care specialists, demonstrating a willingness to embrace tailored interventions for diabetic foot management ( 20 ).In addition, only a minority (37%) report examining daily feet examination, indicating a potential gap in proactive foot care practices among a significant portion of the surveyed population. However, there appears to be a balanced approach to footwear hygiene and selection, with an equal split (50% each) of respondents reporting the use of comfortable, closed, and soft footwear, as well as examining their shoes before wearing them. Furthermore, a substantial majority (68.5%) refrain from walking barefoot outside, demonstrating an awareness of injury risks and the importance of foot protection. While there are varying levels of adherence to recommended foot hygiene practices, such as changing socks daily (71.3%) and regularly cutting toenails (55.6%), there are notable gaps in consistent foot washing with warm water (42.6%) and application of moisturizer (40.7%). Additionally, a minority (32.4%) report regularly visiting a physician for foot check-ups, suggesting room for improvement in accessing professional foot care services. However, there is evidence of proactive footwear maintenance among respondents, with a slight majority (52.8%) regularly changing footwear even without damage. In terms of foot care practices, our study highlights both strengths and areas for improvement, mirroring the findings of Hanley et al. and Pourkazemi et al.( 21 ). While there is a notable willingness to use specialized footwear, consistent with Hanley et al., there are gaps in daily foot examinations and foot hygiene practices, consistent with Pourkazemi et al. ( 21 ). Additionally, the reluctance to regularly visit physicians for foot check-ups resonates with the findings of Desalu et al., suggesting a common challenge in accessing professional foot care services among diabetic patients ( 22 ).Overall, the data underscores the importance of promoting consistent foot care routines and access to professional foot care services among diabetic individuals to optimize foot health outcomes. Regarding expectations of diabetes management, a significant majority (69.4%) believe they can lead a normal life with appropriate management measures, underscoring optimism and resilience in coping with the condition. However, a substantial minority (30.6%) express doubts, highlighting the need for comprehensive support and education to address concerns and facilitate effective self-management strategies.Overall, our data underscores the need for tailored education and support interventions, as emphasized by Al-Hariri et al., to promote adherence to foot care routines and optimize diabetes management outcomes ( 23 ).By addressing the barriers and misconceptions identified in our study, healthcare providers can enhance foot care practices among diabetic individuals, ultimately reducing the risk of complications and improving overall foot health. 37% of our participants stated that they inspect their feet on daily basis, however, a study done in India showed 71.4% of the diabetics were inspecting their feet daily ( 24 ). This may be due to lack of knowledge about proper foot hygiene. Additionally, almost two-third of our participants did not walk barefoot outside, which is comparable to a study done in India were only 7% of the diabetics walk barefoot outside ( 24 ). So, diabetic patients’ education about the importance of good behaviors done in order to prevent any injury. Regarding foot washing, 42.6% do wash their feet with warm water daily and less than the half do dry the cleft between the toes after washing, similar results are shown in a study done in India were less than half of the diabetics dry their feet between toeas after washing them ( 24 ). Educating people about the good foot hygiene will help decrease the infection due to lack of knowledge. Nevertheless, our study showed that about half of our participants inspect their footwear before wearing them, which is comparable to results of previous studies done in China less than half of the patients do inspect their footwear before wearing them ( 25 ). Students and employed patients in our study showed a significantly better attitude towards diabetic foot care than unemployed ones. Having a job typically leads to higher income and potentially exposure to information related to better diabetic foot care practices which could translate into a more positive and clear attitude towards managing diabetes and diabetic foot care ( 4 ). Patients aged between 18–49 and patients with type 1 DM showed a remarkably better attitude towards DFC, this similarity between the 2 classes could be attributed to the fact that young patients most commonly develop DM Type 1. It is found that patients who have had diabetes for > 10 years showed a significantly poorer attitude than those who have been ill for less than 10 years which opposes to the data in a study done in Saudi Arabia by Alshammari et al. where most of the patients who had a better attitude toward diabetic foot and diabetic foot care were patients who had long-standing diabetes of > 5 years ( 11 ). Conclusion The study concludes that there is much more to learn and educate. Participants are aware of the dangers but do not follow proper health care services to prevent complications. Further, and larger studies should be done over this health care issue to provide better outcomes. One of the limitations of our study was the single institution involvement nevertheless this is a central referral hospital with large number of admissions of various Lebanese population .Overall, the integration of both data sets reveals a multifaceted perspective among respondents, emphasizing the importance of tailored education, support, and interventions to promote adherence to foot care routines and optimize diabetes management outcomes. Declarations Ethical Considerations : ethical considerations to all private data were taken by consenting patients to participate into the study. No identities were used in the study. Availability of data and materials : N/A Competing interests : no competing interests Funding : N/A Author’s contribution : The PI will take the role of tutoring, advising, guiding and revising the investigators work. (10% of their time will be allocated for this study). Others investigators will allocate 15% of their time toward this project. All members of the research group will participate in the process of recruitment, data collection, processing and analysis. Data comparison and drawing of conclusions are also expected from all members. References Knoedler TG, Gaertner AP, Wilkinson PJ, Neil Salvapongse A. Incidence, Prevalence, and Outcomes of Hand Manifestations in Patients With Diabetes Mellitus: A Comprehensive Literature Review. Hand (N Y). 2024 Jan 30:15589447231219522. doi: 10.1177/15589447231219522. Epub ahead of print. PMID: 38288717. J Family Med Prim Care. 2023;12(9):2036–41. doi: 10.4103/jfmpc.jfmpc_409_23. Epub 2023 Sep 30. PMID: 38024893; PMCID: PMC10657045. Longendyke R, Grundman JB, Majidi S. Acute and Chronic Adverse Outcomes of Type 1 Diabetes. Endocrinol Metab Clin North Am. 2024;53(1):123–33. 10.1016/j.ecl.2023.09.004 . Epub 2023 Oct 17. PMID: 38272591. Kaur A, Kumar R, Sharma A. Diabetic Retinopathy Leading to Blindness- A Review. Curr Diabetes Rev. 2024 Jan 24. doi: 10.2174/0115733998274599231109034741. Epub ahead of print. PMID: 38275038. Zhu J, Hu Z, Luo Y, Liu Y, Luo W, Du X, Luo Z, Hu J, Peng S. Diabetic peripheral neuropathy: pathogenetic mechanisms and treatment. Front Endocrinol (Lausanne). 2024;14:1265372. 10.3389/fendo.2023.1265372 . PMID: 38264279; PMCID: PMC10803883. Bioinformation. 2023;19(12):1124–8. 10.6026/973206300191124 . PMID: 38250530; PMCID: PMC10794751. Peter PI, Steinberg WJ, van Rooyen C, Botes J. Type 2 diabetes mellitus patients' knowledge, attitude and practice of lifestyle modifications. Health SA. 2022;27:1921. 10.4102/hsag.v27i0.1921 . PMID: 36337447; PMCID: PMC9634683. Peter PI, Steinberg WJ, van Rooyen C, Botes J. Type 2 diabetes mellitus patients' knowledge, attitude and practice of lifestyle modifications. Health SA. 2022;27:1921. 10.4102/hsag.v27i0.1921 . PMID: 36337447; PMCID: PMC9634683. Dillon BR, Ang L, Pop-Busui R. Spectrum of Diabetic Neuropathy: New Insights in Diagnosis and Treatment. Annu Rev Med. 2024;75:293–306. 10.1146/annurev-med-043021-033114 . PMID: 38285516. Shaqran TM, Alqahtani SN, Alhalafi AF, et al. Knowledge, Attitude, and Practices Related to Foot Care Among Diabetic Patients in Tabuk City, Saudi Arabia. Cureus Published online November. 2023;7. 10.7759/cureus.48473 . Alshammari Z, Alsaid L, Parameaswari P, Alzahrani A. Attitude and knowledge about foot care among diabetic patients in Riyadh, Saudi Arabia. J Family Med Prim Care. 2019;8(6):2089. 10.4103/jfmpc.jfmpc_248_19 . Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005;293:217–28. PITOCCO1 D, SPANU2 T, LEO1 MDI, VITIELLO3 R. A. RIZZI1,L. TARTAGLIONE1, B. FIORI2, S. CAPUTO1, G. TINELLI4, F. ZACCARDI1, A. FLEX5, M. GALLI3, A. PONTECORVI6, M. SANGUINETTI2. Diabetic foot infections: a comprehensive overview. Jeffcoate WJ, Harding KG. Diabetic foot ulcers. Lancet. 2003;361:1545–51. Mendes JJ. Diabetic Foot Infections: Current Diagnosis and Treatment.The. J Diabet Foot Complications. 2012;4(1):26–45. Bilal M, Haseeb A, Rehman A, et al. Knowledge, Attitudes, and Practices Among Nurses in Pakistan Towards Diabetic Foot. Cureus Published online July. 2018;19. 10.7759/cureus.3001 . Taksande B, Thote M, Jajoo U. Knowledge, attitude, and practice of foot care in patients with diabetes at central rural India. J Family Med Prim Care. 2017;6(2):284. 10.4103/2249-4863.219994 . Alharbi M, Sulaiman A. Foot care knowledge, attitude and practices of diabetic patients: A survey in Diabetes health care facility. J Family Med Prim Care. 2022;11(7):3816. 10.4103/jfmpc.jfmpc_183_21 . Shamim M, Alhakbani MSA, Alqahtani MSB, Alharthi OSO, Alhaqbani YJN. Knowledge, attitude, and practice regarding diabetic foot care among Saudi and non-Saudi diabetic patients in Alkharj. J Family Med Prim Care. 2021;10(2):859–64. 10.4103/jfmpc.jfmpc_1681_20 . Epub 2021 Feb 27. PMID: 34041089; PMCID: PMC8138424. Hanley G, Chiou P, Liu C, Chen H, Pfeiffer S. Foot Care Knowledge, Attitudes and Practices among Patients with Diabetic Foot and Amputation in St. Kitts and Nevis. Int Wound J. 2020;17(5):1142–52. https://doi.org/10.1111/iwj.13446 . Pourkazemi A, Ghanbari A, Khojamli M, et al. Diabetic foot care: knowledge and practice. BMC Endocr Disord. 2020;20(1):40. 10.1186/s12902-020-0512-y . Desalu O, Salawu F, Jimoh A, Adekoya A, Busari O, Olokoba A. Diabetic foot care: Self reported knowledge and practice among patients attending three tertiary hospital in Nigeria. Ghana Med J. 2011;45(2). 10.4314/gmj.v45i2.68930 . Al-Hariri MT, Al-Enazi AS, Alshammari DM, Bahamdan AS, AL-Khtani SM, Al-Abdulwahab AA. Descriptive study on the knowledge, attitudes and practices regarding the diabetic foot. J Taibah Univ Med Sci. 2017;12(6):492–6. 10.1016/j.jtumed.2017.02.001 . Paramasivam S, Ramalingam G, Gani ARP. Foot Self-Care Practices among Diabetic Patients Attending a Teaching Hospital in Tamil Nadu, India. J Family Med Prim Care. 2023;12(9):2036–41. https://doi.org/10.4103/jfmpc.jfmpc_409_23 . Untari EK, Andayani TM, Yasin NM, Asdie RH. A Review of Patient's Knowledge and Practice of Diabetic Foot Self-Care. Malays J Med Sci. 2024;31(1):33–50. 10.21315/mjms2024.31.1.3 . Epub 2024 Feb 20. PMID: 38456109; PMCID: PMC10917598. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4165910","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":283910680,"identity":"26a7187c-184d-45b2-9850-889d554a1a5b","order_by":0,"name":"Reem Al Makari","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+klEQVRIiWNgGAWjYNCCAgYGCSB14GMDiMfYeICwFgOIloMzG0A0YwPxWph5wVqA1uFTbD4jO4Hhh8E2ecn2sw8P2+6wqdNtPwy0pcYmGpcWmRu5Gxh7DG4bzuZJNziceyZNwuxMIlDLsbTcBhxaJCRyt//gMbjNOI8hjeFwbtthCbMDQC2MDYfxadnA+Mfgtv08/mcMhy1BWs4/JKyFGWhL4mwJoC2MIC03CNnC83YDs4zB7eSZM54xHOxtS5PcdgNoSwI+v7ADHfam4rbtjPNpzB9+ttnwm51Pf/jgQ40NTi0MAgnYRLEKwgD/AXyyo2AUjIJRMAqAAABfvWKcgCgJdQAAAABJRU5ErkJggg==","orcid":"","institution":"Beirut Arab University","correspondingAuthor":true,"prefix":"","firstName":"Reem","middleName":"Al","lastName":"Makari","suffix":""},{"id":283910681,"identity":"6d786234-cdca-49eb-af95-6c6c42242e0e","order_by":1,"name":"Lynn Saifeddine","email":"","orcid":"","institution":"Beirut Arab University","correspondingAuthor":false,"prefix":"","firstName":"Lynn","middleName":"","lastName":"Saifeddine","suffix":""},{"id":283910682,"identity":"78adc663-1e92-45f4-bc3a-6caa7a077790","order_by":2,"name":"Nadia Al Masri","email":"","orcid":"","institution":"Beirut Arab University","correspondingAuthor":false,"prefix":"","firstName":"Nadia","middleName":"Al","lastName":"Masri","suffix":""},{"id":283910683,"identity":"9944dfa0-d14a-40a2-8efd-1e5ce584e1fb","order_by":3,"name":"Hassan Balhas","email":"","orcid":"","institution":"Beirut Arab University","correspondingAuthor":false,"prefix":"","firstName":"Hassan","middleName":"","lastName":"Balhas","suffix":""},{"id":283910684,"identity":"a7ef76f8-14a4-4053-8366-4c0d58d02e50","order_by":4,"name":"Abbas Sader","email":"","orcid":"","institution":"Beirut Arab University","correspondingAuthor":false,"prefix":"","firstName":"Abbas","middleName":"","lastName":"Sader","suffix":""},{"id":283910687,"identity":"ca676373-17c8-488c-b562-231bb7278daa","order_by":5,"name":"Roy Aboulhosn","email":"","orcid":"","institution":"Beirut Arab University","correspondingAuthor":false,"prefix":"","firstName":"Roy","middleName":"","lastName":"Aboulhosn","suffix":""},{"id":283910689,"identity":"d34c8920-1c56-4043-b0ca-010b5ef860bd","order_by":6,"name":"Bilal Azakir","email":"","orcid":"","institution":"Beirut Arab University","correspondingAuthor":false,"prefix":"","firstName":"Bilal","middleName":"","lastName":"Azakir","suffix":""},{"id":283910691,"identity":"4d4386aa-18bb-4692-8f29-e936f7b61db6","order_by":7,"name":"Ghenwa Dakdouki","email":"","orcid":"","institution":"Hammoud Hospital University Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Ghenwa","middleName":"","lastName":"Dakdouki","suffix":""}],"badges":[],"createdAt":"2024-03-25 23:44:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4165910/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4165910/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":53926852,"identity":"31e8c04e-9846-46b3-a47c-62c915ffd07e","added_by":"auto","created_at":"2024-04-02 10:05:34","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":388838,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4165910/v1/a40e8496-9a1f-4dfd-8c3e-f4c3882ad1b1.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Knowledge, attitudes, and practices of Footcare in Diabetic patients in Hammoud University Medical Center","fulltext":[{"header":"Background","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003eDiabetes mellitus and its complications\u003c/h2\u003e \u003cp\u003eDiabetes mellitus is a metabolic heterogeneous disease characterized with episodes of hyperglycemia and glucose intolerance, due to deficiency in insulin or lack in insulin action or both (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Diabetes is a chronic disease that requires continuous strict monitoring of the glycemic levels to prevent short term and long-term complications. Awareness and patient education about the importance of regular exercise, weight loss, healthy diet and controlling blood sugar plays an important role in preventing acute complications and reducing long term complications (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).Despite healthy lifestyle and precautious measures, the longer you have diabetes and the lower your control to glycemic level the higher the incidence to have complication. Diabetes can cause both acute and chronic complications (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Acute complications might manifest as diabetic ketoacidosis DKA, and hyperglycemic hyperosmolar state HHS, and lactic acidosis. However, chronic complications are further subdivided into micro and macro vascular complications, with retinopathy, nephropathy and neuropathy representing micro vascular complications (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) and cardiac, cerebral and vascular representing macro vascular complications. The most encountered micro vascular complications are diabetic retinopathy and nephropathy, manifesting as visual impairment or even blindness and chronic kidney disease respectively(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Additionally, peripheral neuropathy was highly prevalent complication in both type 1 diabetes (T1D) and type 2 diabetes (T2D), with a prevalence exceeding 50% in type 2 who are diabetic for more than 10 years (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eFoot ulcers in diabetic patients\u003c/h3\u003e\n\u003cp\u003eAs healthcare workers control outside consultation room is limited (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Amongst the wide range of complications that accompany diabetes mellitus, diabetic foot infections stand out as one of the most challenging. Almost all patients with DM are at risk of developing diabetic foot infections with current studies showing that the prevalence of developing foot ulcers is 4\u0026ndash;10%, the annual population based incidence is 1.0\u0026ndash;4.1% and the lifetime incidence my reach as high as 25%(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Infections in ulcerated feet in patients with DM pose a major cause for morbidity in those patients, in addition to discomfort, increased number of visits to health-care providers, wound care and antimicrobial therapy (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWith infections being the most common cause (more than 50%), patients with DFIs frequently require minor or major amputations of the lower limbs ( 15\u0026ndash;27%)(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMajor amputations are associated with significant morbidity and mortality (ranging from 13 to 40% at 1 year to 39 to 80% at 5 years 2) in addition to psychological and financial consequences (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). It has been reported that nearly 70% of nontraumatic amputations were performed due to a diabetic foot(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Diabetic foot ulcer is defined as any necrosis, gangrene, or full-thickness skin defect occurring distal to the ankle in a diabetic patient(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).Many reports showed that this problem is the most frequent cause of hospitalization for diabetic patients, representing up to 25% of all hospital admissions of diabetic patients.(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e\n\u003ch3\u003eKnowledge, attitude, and practices about foot care in diabetic patients\u003c/h3\u003e\n\u003cp\u003eDiabetic foot care is extremely important for patients and their health(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). They should be well educated about their disease and the complications caused. For instance diabetic patients should have received education about the sensation loss and decrease blood flow they will have with time(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). These patients should also be aware of checking their sole of the feet and any developing ulcer due to delayed wound healing(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Many patients have deficit about the knowledge of these practices and that\u0026rsquo;s why it is very important to address these specific deficits in order to improve overall diabetic foot care.This point was revealed by \u003cb\u003eShamim et al.'s research in Alkharj\u003c/b\u003e, Saudi Arabia, which investigates the knowledge, attitudes, and practices regarding diabetic foot care among both Saudi and non-Saudi diabetic patients. The study provides valuable insights into the diverse population and their approach to foot care.It sheds light on the difference of approach to diabetic foot care in relation to different geographical and cultural context (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe Saudi study mentioned that \u0026gt;\u0026thinsp;70% of the participants are well educated about diabetic foot care and how to deal with it (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). It was also seen that in another study in Riyadh confirmed that Saudian\u0026rsquo;s have good knowledge about the topic (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Questions like the blood flow to the feet, the awareness of developing ulcers, and the loss of sensation in diabetic patients were asked in both studies (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Another study done in Pakistan showed that nurses do educate patients about diabetic foot care for prevention rather than reaching ulcers and having to treat (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Unlike rural parts of India where studies have found poor knowledge of diabetic foot care (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEven though researches found good knowledge about diabetes and its complication the attitudes and practices are still poor. Performing a good attitude and practice includes clinical visits to the doctor, proper medication use, and proper treatment of sores (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Fortunately the source of knowledge in major studies was from physicians and nurses (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Shaqran et al revealed that participants perform regular exercises, take their medications properly, and take advices from specialist which indicates good attitudes (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePractice levels in a study conducted by Alharbi et al. were average of 56% with performing good foot care as washing daily ,applying moisturizers, drying them, and inspecting shoes before wearing daily (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Also, it was proven that those with longer duration of diabetes had better practices than those with shorter duration (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). That\u0026rsquo;s exactly why diabetic patient foot care practice is extremely and crucially important for limb preservation to avoid amputation and the loss that varies from toes till whole foot amputation which was proved by The study by \u003cb\u003eHanley et al.\u003c/b\u003e that focuses on diabetic foot care practices among patients with foot complications and amputation in \u003cb\u003eSt. Kitts and Nevis\u003c/b\u003e (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). No single study was found in Lebanon to address the issue and upon this the following research was conducted. Saudi Arabia was the main country to address foot care in diabetic patients and we have adopted their question to conduct ours. This research draws attention to the critical aspects of foot care in preventing severe complications.\u003c/p\u003e "},{"header":"Subjects (Material) and Methods","content":"\u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eStudy design\u003c/b\u003e: a cross sectional study targeting diabetic patients in HUMC\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eStudy place: Hamoud University Medical Center\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eStudy population (inclusion criteria \u0026amp;exclusion criteria): All Diabetic patients admitted to HUMC\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eStudy period: Surveying and data collection will start directly after the IRB approval. One year is the estimated time to complete this study.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eSampling (type \u0026amp;size): There will be no sampling carried out for the purpose of this study. Nevertheless, 108 diabetic patients are included. Participants are to be interviewed with no upper limit. The minimum sample size was calculated based on confidence level of 95%, margin of error of 5%, these measures were selected to ensure that enough power can be achieved to test different hypotheses through future further analysis of the results.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eData collection procedures and tools: All research participants will be approached by the investigators whereby the aims of the study will be explained and consenting will take place.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eThe investigators will interview diabetic patients with a questionnaire targeting the aim of the research. It will take 5\u0026ndash;10 minutes only. Plan of data processing and analysis: Processing of data will include data entry that will be entered into a Microsoft Excel spreadsheet which will be designed specifically for this study resembling the paper forms (same order of questions\u0026hellip;) to avoid data entry mistake. After that, data will be transferred into the Statistical Package of Social Science (IBM SPSS, version 23) which will be used for data cleaning, management, and analyses using built range checks with automatic error prompts. In addition, we will perform ascending/ descending order view of variables and descriptive histograms that will easily identify outliers. Descriptive analyses will be carried out by calculating the mean and standard deviation for continuous variables, and number and percent for categorical ones. Knowledge, attitudes, and practices are analyzed as mean scores and compared using ANOVA and t-tests with the provided factors.\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe study included 108 participants of mean age was 60.14\u0026thinsp;\u0026plusmn;\u0026thinsp;15.3. The majority of participants are males 64.8% ( n\u0026thinsp;=\u0026thinsp;70), 34.3% (n\u0026thinsp;=\u0026thinsp;37) are of university level, 27.8% (n\u0026thinsp;=\u0026thinsp;30) are of high school level, and 11% (n\u0026thinsp;=\u0026thinsp;12) are with no education level. Almost half of the participants 51.9% (n\u0026thinsp;=\u0026thinsp;56) are employed and 66.7% (n\u0026thinsp;=\u0026thinsp;72) are married. 75.9% (n\u0026thinsp;=\u0026thinsp;82) of the participants are Lebanese and 56.5% (n\u0026thinsp;=\u0026thinsp;61) are smokers. As for diabetic complications and other comorbidities, 78.7% (n\u0026thinsp;=\u0026thinsp;85) are hypertensive, 31.5% (n\u0026thinsp;=\u0026thinsp;34) are with renal disease, 58.3% (n\u0026thinsp;=\u0026thinsp;63) are with dyslipidemia ,39.8% (n\u0026thinsp;=\u0026thinsp;43) are with heart disease, and 23.1% (n\u0026thinsp;=\u0026thinsp;25) suffer of retinopathy (Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParticipants' Demographics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDemographics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026plusmn;\u0026thinsp;15.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage %\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e64.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMarital Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eElementary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMiddle School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUniversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigher Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRetired\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNationality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLebanese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePalestinian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSmoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e56.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e78.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRenal Disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e68.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDyslipidemia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHeart Disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRetinopathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, the majority of participants are with diabetes type 2 89.8% (n\u0026thinsp;=\u0026thinsp;97). 68.5% (n\u0026thinsp;=\u0026thinsp;74) had diabetes for more than 10 years and 37% (n\u0026thinsp;=\u0026thinsp;40) were of uncontrolled Hba1c. The mean value of Hba1c was 7.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.88. As for their medication 67.6% (n\u0026thinsp;=\u0026thinsp;73) of the participants are on oral agents and only 4.6% (n\u0026thinsp;=\u0026thinsp;5) are on diet only. 34.3% (n\u0026thinsp;=\u0026thinsp;37) have current foot ulcers and 21.3% (n\u0026thinsp;=\u0026thinsp;37) have reported multiple foot problems. 26.9% (n\u0026thinsp;=\u0026thinsp;29) had amputation and 51.9% (n\u0026thinsp;=\u0026thinsp;56) have received advice on diabetic foot care.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ediabetes and its complications\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDiabetes and diabetic complications\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency(n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage %\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDiabetes type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eType 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eType2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e89.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDuration of Diabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;10 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;10 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e68.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eLast Reading of Hba1c\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControlled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUncontrolled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHighly Uncontrolled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eDiabetes Treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOral Agent (s)15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInsulin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOral Agents and Insulin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eFoot Complaints\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCurrent Ulcer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHealed Ulcer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eSensation problem in feet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFoot Pain at rest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMultiple Problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFoor Pain during walking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNumbness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAmputation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eReceived advice on Diabetic foot\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eValue of Hba1c\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026plusmn;\u0026thinsp;1.88\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAs for the knowledge section, participants answered 11 questions. 92.6% (n\u0026thinsp;=\u0026thinsp;100) knew that diabetics develop foot ulcers, 92.6% (n\u0026thinsp;=\u0026thinsp;100) knew that diabetics develop reduced blood flow in their feet, 97.2% (n\u0026thinsp;=\u0026thinsp;105) knew that taking medications regularly reduces diabetic complications and 93.5% (n\u0026thinsp;=\u0026thinsp;101) knew that it is important to examine foot ware for any tear or object ( Table\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eKnowledge\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eKnowledge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage %\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDiabetics develops foot ulcers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e92.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDiabetics develops reduced blood flow in their feet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e91.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDiabetics develops reduced sensation in their feet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e92.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePoor circulation develops from smoking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e92.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eImportant to examine sole because diabetics develop poor sensation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWounds and infections do not heal quickly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e95.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTaking medication regularly reduce DM complications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e97.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eIt is important to examine foot ware for any tear or object\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFoot gangrene is one complication of DM foot infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you think exercise will help reduce complications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88.9%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eUncontrolled diabetes leads to foot deformity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e92.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e demonstrates the attitude of participants for diabetic foot care. 58.3% (n\u0026thinsp;=\u0026thinsp;63) said that they can take responsibility of daily examination of their feet and foot ware. 69.4% (n\u0026thinsp;=\u0026thinsp;75) are able to live normal life with appropriate measures of diabetes and 68.5% (n\u0026thinsp;=\u0026thinsp;74) can use special foot ware advised by foot-care specialist.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAttitude\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAttitude\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage %\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCan you perform regular exercise and change your food habits to prevent further diabetic complications?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCan you take the responsibility of daily examination of your feet and foot ware, as well as regular footcare specialist consultation?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCan you use special foot ware adviced by foot-care specialist?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e68.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWill you wear footwear indoors as advised by your foot-care specialist?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e64.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCan you be able to live a normal life with appropriate measures for diabetes?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e reveals the practices of diabetic foot care among the participants. Half of the participants claimed that they used comfortable, closed, and soft foot ware and examined their shoes before wearing them whereas the other half did not. Only 33.3% (n\u0026thinsp;=\u0026thinsp;36) said that they continuously wear cotton socks, and 32.4% (n\u0026thinsp;=\u0026thinsp;35) said that regularly visit physicians for foot checkups. 42.6% (n\u0026thinsp;=\u0026thinsp;46) only claimed that they wash their feet and dry in between the toes daily and regularly. 55.6% (n\u0026thinsp;=\u0026thinsp;60) of the participants regularly cut their toenails.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePractices\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003ePractices\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage %\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you examine your feet daily ?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you use comfortable, closed, and soft foot wear?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you examine your shoes before wearing them?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you walk barefoot, outside?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e68.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you continuously wear cotton socks?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you examine your feet for any marks resulting from shoes/socks?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you change your socks daily ?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you daily wash your feet with warm water?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you carefully dry the cleft between toes after washing?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you apply moisturizer daily on your feet?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you cut your toenails regularly?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you regularly visit a physician for a foot check-up?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67.6%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you regularly change foot-wear even without damage?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAs for studying the relation between knowledge and different factors, Table \u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e showed that none of the factors was significantly related to knowledge out of total score of 11. For example, the mean score of those between 18 and 49 was slightly higher than the other age group (score\u0026thinsp;=\u0026thinsp;10.5/11) but p-value\u0026thinsp;=\u0026thinsp;0.76. males and females were with almost equal mean score but p-value\u0026thinsp;\u0026gt;\u0026thinsp;0.05. Also, it was shown that those with longer duration of diabetes scored higher than those with short term but with no significant value. In general, all mean values of the categories were higher than 9.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eKnowledge Correlated to different factors\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKnowledge Score Mean /11\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eAge (Years)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.764\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.07\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.26\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eGender\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.381\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMarital Status\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.266\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eEducation\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e0.138\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElementary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.62\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUniversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigher Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eOccupation\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.498\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRetired\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.55\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eSmoker\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eDiabetes type\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.453\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eDuration of Diabetes\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;10 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.115\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;10 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eLast Reading of Hba1c\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControlled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.201\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUncontrolled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.65\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHighly Uncontrolled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.61\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAs for the relation between attitude and variables, the results are demonstrated in Table \u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e. It was significantly proven with p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001 that those of age group 18\u0026ndash;49 were of best attitude (4.25/5). In addition, those who are single had the best attitude 4.05/5 with p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Education, occupation, type of diabetes, and diabetes duration were statistically significant with p-values\u0026thinsp;\u0026lt;\u0026thinsp;0.05. smoking, control of Hba1c, and gender was not statistically significant.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eatittude Correlated to different factors\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAttitude Score Mean /5\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eAge (Years)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.54\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eGender\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.969\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMarital Status\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eEducation\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElementary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUniversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigher Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eOccupation\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.76\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRetired\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eSmoker\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.228\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eDiabetes type\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eDuration of Diabetes\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;10 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;10 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eLast Reading of Hba1c\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControlled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUncontrolled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHighly Uncontrolled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn Table \u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e, relations between practices of mean score out of 13 questions is shown. Gender did not differ in practices with both mean score like each other. Those single were more likely to perform proper practices than others with mean score 7.28/13 and p-value\u0026thinsp;=\u0026thinsp;0.031. Those employed had the highest score 8 with statistically significant p- value\u0026thinsp;\u0026lt;\u0026thinsp;0.05. finally, those with longer duration of diabetes\u0026thinsp;\u0026gt;\u0026thinsp;10 years were statistically proven to perform better practices with a statistically proven p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePractices correlated to different factors\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePractice Score Mean /13\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eAge (Years)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.244\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eGender\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.97\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMarital Status\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.031\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eEducation\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e0.113\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElementary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUniversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigher Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eOccupation\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.039\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.39\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.07\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRetired\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.11\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eSmoker\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eDiabetes type\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.144\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.76\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eDuration of Diabetes\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;10 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;10 Years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.42\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eLast Reading of Hba1c\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControlled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.508\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUncontrolled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHighly Uncontrolled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.83\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study\u0026rsquo;s aim is to assess and highlight the knowledge, attitudes and practices of foot care among diabetic patients in Hammoud University Medical Center, Lebanon.In contrast to other previous studies which demonstrated that patients with a higher level of education possess a greater understanding of diabetic foot care(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e), the data from our study suggests that uneducated patients have similar knowledge of diabetic foot care in comparison to educated ones. Our study data also shows that single or divorced patients have greater knowledge than those who are married. This opposes to the idea of spousal support, in terms of nutrition, commitment, treatment and better coping with long term diseases, that comes with being married (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). patients who have had diabetes for \u0026gt;\u0026thinsp;10 showed more knowledge similarly to a study in Saudi Arabia (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). As mentioned in that study, this could be due to the patient\u0026rsquo;s long-term exposure to the disease which lead to more experience and better handling in term of diabetic foot care.\u003c/p\u003e \u003cp\u003eA significant majority of respondents (92.6%) recognize the high likelihood of diabetics developing foot ulcers, reduced blood flow, and reduced sensation in their feet, indicating a robust awareness of the significant risks associated with diabetes-related foot complications just like Alshammari et al.that found that a majority of diabetic patients recognized the risks associated with foot complication similar to the high awareness observed in our study (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Additionally, while 97.2% believe that regular medication intake can reduce diabetes complications, there remains a need to address skepticism regarding exercise, with 88.9% acknowledging its potential benefits, and 11.1% expressing doubts.Moreover, the skepticism towards exercise reported in our data echoes findings by Taksande et al., indicating a common trend in addressing lifestyle modifications among diabetic individuals (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eRespondents' willingness to engage in preventive measures and lifestyle modifications reflects a proactive stance towards self-care. Notably, 55.6% express confidence in their ability to incorporate regular exercise and dietary changes to prevent further diabetic complications. However, a significant portion (44.4%) appears uncertain or hesitant, suggesting potential barriers or misconceptions hindering adherence to lifestyle modifications.\u003c/p\u003e \u003cp\u003eFurthermore, a majority (58.3%) are willing to take responsibility for daily foot examinations, foot ware maintenance, and regular consultations with foot-care specialists,in contrast a notable proportion (41.7%) express hesitation or reluctance, indicating challenges in implementing consistent foot care routines. Nonetheless, the majority (68.5%) are open to using specialized foot ware recommended by foot-care specialists, demonstrating a willingness to embrace tailored interventions for diabetic foot management (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).In addition, only a minority (37%) report examining daily feet examination, indicating a potential gap in proactive foot care practices among a significant portion of the surveyed population. However, there appears to be a balanced approach to footwear hygiene and selection, with an equal split (50% each) of respondents reporting the use of comfortable, closed, and soft footwear, as well as examining their shoes before wearing them. Furthermore, a substantial majority (68.5%) refrain from walking barefoot outside, demonstrating an awareness of injury risks and the importance of foot protection. While there are varying levels of adherence to recommended foot hygiene practices, such as changing socks daily (71.3%) and regularly cutting toenails (55.6%), there are notable gaps in consistent foot washing with warm water (42.6%) and application of moisturizer (40.7%). Additionally, a minority (32.4%) report regularly visiting a physician for foot check-ups, suggesting room for improvement in accessing professional foot care services. However, there is evidence of proactive footwear maintenance among respondents, with a slight majority (52.8%) regularly changing footwear even without damage. In terms of foot care practices, our study highlights both strengths and areas for improvement, mirroring the findings of Hanley et al. and Pourkazemi et al.(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). While there is a notable willingness to use specialized footwear, consistent with Hanley et al., there are gaps in daily foot examinations and foot hygiene practices, consistent with Pourkazemi et al. (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Additionally, the reluctance to regularly visit physicians for foot check-ups resonates with the findings of Desalu et al., suggesting a common challenge in accessing professional foot care services among diabetic patients (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).Overall, the data underscores the importance of promoting consistent foot care routines and access to professional foot care services among diabetic individuals to optimize foot health outcomes.\u003c/p\u003e \u003cp\u003eRegarding expectations of diabetes management, a significant majority (69.4%) believe they can lead a normal life with appropriate management measures, underscoring optimism and resilience in coping with the condition. However, a substantial minority (30.6%) express doubts, highlighting the need for comprehensive support and education to address concerns and facilitate effective self-management strategies.Overall, our data underscores the need for tailored education and support interventions, as emphasized by Al-Hariri et al., to promote adherence to foot care routines and optimize diabetes management outcomes (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e).By addressing the barriers and misconceptions identified in our study, healthcare providers can enhance foot care practices among diabetic individuals, ultimately reducing the risk of complications and improving overall foot health.\u003c/p\u003e \u003cp\u003e37% of our participants stated that they inspect their feet on daily basis, however, a study done in India showed 71.4% of the diabetics were inspecting their feet daily (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). This may be due to lack of knowledge about proper foot hygiene.\u003c/p\u003e \u003cp\u003eAdditionally, almost two-third of our participants did not walk barefoot outside, which is comparable to a study done in India were only 7% of the diabetics walk barefoot outside (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). So, diabetic patients\u0026rsquo; education about the importance of good behaviors done in order to prevent any injury.\u003c/p\u003e \u003cp\u003eRegarding foot washing, 42.6% do wash their feet with warm water daily and less than the half do dry the cleft between the toes after washing, similar results are shown in a study done in India were less than half of the diabetics dry their feet between toeas after washing them (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Educating people about the good foot hygiene will help decrease the infection due to lack of knowledge.\u003c/p\u003e \u003cp\u003eNevertheless, our study showed that about half of our participants inspect their footwear before wearing them, which is comparable to results of previous studies done in China less than half of the patients do inspect their footwear before wearing them (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStudents and employed patients in our study showed a significantly better attitude towards diabetic foot care than unemployed ones. Having a job typically leads to higher income and potentially exposure to information related to better diabetic foot care practices which could translate into a more positive and clear attitude towards managing diabetes and diabetic foot care (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePatients aged between 18\u0026ndash;49 and patients with type 1 DM showed a remarkably better attitude towards DFC, this similarity between the 2 classes could be attributed to the fact that young patients most commonly develop DM Type 1.\u003c/p\u003e \u003cp\u003eIt is found that patients who have had diabetes for \u0026gt;\u0026thinsp;10 years showed a significantly poorer attitude than those who have been ill for less than 10 years which opposes to the data in a study done in Saudi Arabia by Alshammari et al. where most of the patients who had a better attitude toward diabetic foot and diabetic foot care were patients who had long-standing diabetes of \u0026gt;\u0026thinsp;5 years (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study concludes that there is much more to learn and educate. Participants are aware of the dangers but do not follow proper health care services to prevent complications. Further, and larger studies should be done over this health care issue to provide better outcomes. One of the limitations of our study was the single institution involvement nevertheless this is a central referral hospital with large number of admissions of various Lebanese population .Overall, the integration of both data sets reveals a multifaceted perspective among respondents, emphasizing the importance of tailored education, support, and interventions to promote adherence to foot care routines and optimize diabetes management outcomes.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Considerations\u003c/strong\u003e: \u0026nbsp;ethical considerations to all private data were taken by consenting patients to participate into the study. No identities were used in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials :\u003c/strong\u003e N/A\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e: no competing interests\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding :\u003c/strong\u003e N/A\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor\u0026rsquo;s contribution :\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cul style=\"list-style-type: circle;\"\u003e\n \u003cli\u003eThe PI will take the role of tutoring, advising, guiding and revising the investigators work. (10% of their time will be allocated for this study).\u003c/li\u003e\n \u003cli\u003eOthers investigators will allocate 15% of their time toward this project.\u003c/li\u003e\n \u003cli\u003eAll members of the research group will participate in the process of recruitment, data collection, processing and analysis.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eData comparison and drawing of conclusions are also expected from all members.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKnoedler TG, Gaertner AP, Wilkinson PJ, Neil Salvapongse A. Incidence, Prevalence, and Outcomes of Hand Manifestations in Patients With Diabetes Mellitus: A Comprehensive Literature Review. Hand (N Y). 2024 Jan 30:15589447231219522. doi: 10.1177/15589447231219522. Epub ahead of print. PMID: 38288717.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJ Family Med Prim Care. 2023;12(9):2036\u0026ndash;41. doi: 10.4103/jfmpc.jfmpc_409_23. Epub 2023 Sep 30. PMID: 38024893; PMCID: PMC10657045.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLongendyke R, Grundman JB, Majidi S. Acute and Chronic Adverse Outcomes of Type 1 Diabetes. Endocrinol Metab Clin North Am. 2024;53(1):123\u0026ndash;33. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.ecl.2023.09.004\u003c/span\u003e\u003cspan address=\"10.1016/j.ecl.2023.09.004\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2023 Oct 17. PMID: 38272591.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKaur A, Kumar R, Sharma A. Diabetic Retinopathy Leading to Blindness- A Review. Curr Diabetes Rev. 2024 Jan 24. doi: 10.2174/0115733998274599231109034741. Epub ahead of print. PMID: 38275038.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhu J, Hu Z, Luo Y, Liu Y, Luo W, Du X, Luo Z, Hu J, Peng S. Diabetic peripheral neuropathy: pathogenetic mechanisms and treatment. Front Endocrinol (Lausanne). 2024;14:1265372. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fendo.2023.1265372\u003c/span\u003e\u003cspan address=\"10.3389/fendo.2023.1265372\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 38264279; PMCID: PMC10803883.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBioinformation. 2023;19(12):1124\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.6026/973206300191124\u003c/span\u003e\u003cspan address=\"10.6026/973206300191124\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 38250530; PMCID: PMC10794751.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePeter PI, Steinberg WJ, van Rooyen C, Botes J. Type 2 diabetes mellitus patients' knowledge, attitude and practice of lifestyle modifications. Health SA. 2022;27:1921. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4102/hsag.v27i0.1921\u003c/span\u003e\u003cspan address=\"10.4102/hsag.v27i0.1921\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 36337447; PMCID: PMC9634683.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePeter PI, Steinberg WJ, van Rooyen C, Botes J. Type 2 diabetes mellitus patients' knowledge, attitude and practice of lifestyle modifications. Health SA. 2022;27:1921. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4102/hsag.v27i0.1921\u003c/span\u003e\u003cspan address=\"10.4102/hsag.v27i0.1921\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 36337447; PMCID: PMC9634683.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDillon BR, Ang L, Pop-Busui R. Spectrum of Diabetic Neuropathy: New Insights in Diagnosis and Treatment. Annu Rev Med. 2024;75:293\u0026ndash;306. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1146/annurev-med-043021-033114\u003c/span\u003e\u003cspan address=\"10.1146/annurev-med-043021-033114\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. PMID: 38285516.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShaqran TM, Alqahtani SN, Alhalafi AF, et al. Knowledge, Attitude, and Practices Related to Foot Care Among Diabetic Patients in Tabuk City, Saudi Arabia. Cureus Published online November. 2023;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.7759/cureus.48473\u003c/span\u003e\u003cspan address=\"10.7759/cureus.48473\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlshammari Z, Alsaid L, Parameaswari P, Alzahrani A. Attitude and knowledge about foot care among diabetic patients in Riyadh, Saudi Arabia. J Family Med Prim Care. 2019;8(6):2089. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4103/jfmpc.jfmpc_248_19\u003c/span\u003e\u003cspan address=\"10.4103/jfmpc.jfmpc_248_19\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSingh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005;293:217\u0026ndash;28.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePITOCCO1 D, SPANU2 T, LEO1 MDI, VITIELLO3 R. A. RIZZI1,L. TARTAGLIONE1, B. FIORI2, S. CAPUTO1, G. TINELLI4, F. ZACCARDI1, A. FLEX5, M. GALLI3, A. PONTECORVI6, M. SANGUINETTI2. Diabetic foot infections: a comprehensive overview.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJeffcoate WJ, Harding KG. Diabetic foot ulcers. Lancet. 2003;361:1545\u0026ndash;51.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMendes JJ. Diabetic Foot Infections: Current Diagnosis and Treatment.The. J Diabet Foot Complications. 2012;4(1):26\u0026ndash;45.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBilal M, Haseeb A, Rehman A, et al. Knowledge, Attitudes, and Practices Among Nurses in Pakistan Towards Diabetic Foot. Cureus Published online July. 2018;19. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.7759/cureus.3001\u003c/span\u003e\u003cspan address=\"10.7759/cureus.3001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTaksande B, Thote M, Jajoo U. Knowledge, attitude, and practice of foot care in patients with diabetes at central rural India. J Family Med Prim Care. 2017;6(2):284. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4103/2249-4863.219994\u003c/span\u003e\u003cspan address=\"10.4103/2249-4863.219994\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlharbi M, Sulaiman A. Foot care knowledge, attitude and practices of diabetic patients: A survey in Diabetes health care facility. J Family Med Prim Care. 2022;11(7):3816. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4103/jfmpc.jfmpc_183_21\u003c/span\u003e\u003cspan address=\"10.4103/jfmpc.jfmpc_183_21\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShamim M, Alhakbani MSA, Alqahtani MSB, Alharthi OSO, Alhaqbani YJN. Knowledge, attitude, and practice regarding diabetic foot care among Saudi and non-Saudi diabetic patients in Alkharj. J Family Med Prim Care. 2021;10(2):859\u0026ndash;64. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4103/jfmpc.jfmpc_1681_20\u003c/span\u003e\u003cspan address=\"10.4103/jfmpc.jfmpc_1681_20\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2021 Feb 27. PMID: 34041089; PMCID: PMC8138424.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHanley G, Chiou P, Liu C, Chen H, Pfeiffer S. Foot Care Knowledge, Attitudes and Practices among Patients with Diabetic Foot and Amputation in St. Kitts and Nevis. Int Wound J. 2020;17(5):1142\u0026ndash;52. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/iwj.13446\u003c/span\u003e\u003cspan address=\"10.1111/iwj.13446\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePourkazemi A, Ghanbari A, Khojamli M, et al. Diabetic foot care: knowledge and practice. BMC Endocr Disord. 2020;20(1):40. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12902-020-0512-y\u003c/span\u003e\u003cspan address=\"10.1186/s12902-020-0512-y\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDesalu O, Salawu F, Jimoh A, Adekoya A, Busari O, Olokoba A. Diabetic foot care: Self reported knowledge and practice among patients attending three tertiary hospital in Nigeria. Ghana Med J. 2011;45(2). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4314/gmj.v45i2.68930\u003c/span\u003e\u003cspan address=\"10.4314/gmj.v45i2.68930\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl-Hariri MT, Al-Enazi AS, Alshammari DM, Bahamdan AS, AL-Khtani SM, Al-Abdulwahab AA. Descriptive study on the knowledge, attitudes and practices regarding the diabetic foot. J Taibah Univ Med Sci. 2017;12(6):492\u0026ndash;6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jtumed.2017.02.001\u003c/span\u003e\u003cspan address=\"10.1016/j.jtumed.2017.02.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eParamasivam S, Ramalingam G, Gani ARP. Foot Self-Care Practices among Diabetic Patients Attending a Teaching Hospital in Tamil Nadu, India. J Family Med Prim Care. 2023;12(9):2036\u0026ndash;41. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.4103/jfmpc.jfmpc_409_23\u003c/span\u003e\u003cspan address=\"10.4103/jfmpc.jfmpc_409_23\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUntari EK, Andayani TM, Yasin NM, Asdie RH. A Review of Patient's Knowledge and Practice of Diabetic Foot Self-Care. Malays J Med Sci. 2024;31(1):33\u0026ndash;50. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.21315/mjms2024.31.1.3\u003c/span\u003e\u003cspan address=\"10.21315/mjms2024.31.1.3\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2024 Feb 20. PMID: 38456109; PMCID: PMC10917598.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Diabetic, Footcare, Ulcer, Lebanon, knowledge, Attitude, Practices","lastPublishedDoi":"10.21203/rs.3.rs-4165910/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4165910/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction and literature:\u003c/strong\u003e Diabetes mellitus is a metabolic heterogeneous disease that requires long-term management and is accompanied by several complications. Diabetic foot is one of the important complications encountered by diabetes. it arises to multiple vascular and neurological complications that diabetes results in. Patients need to be advised and follow the physicians' instructions to maintain the best outcomes. our study aims to tackle the knowledge, attitudes, and practices of diabetics regarding diabetic foot care at Hamoud Unversity Medical Center.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e a total of 108 patients in Hamoud University Medical Center were questioned after obtaining the hospital IRB approval. Results were entered and analyzed by Spss v23. quantitative data were analyzed as means and qualitative as frequencies and percentages. The scores were calculated into means, ANOVA, and t-tests were used to find correlations between scores and factors with significant p-values \u0026lt;0.05.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThe study included 108 participants of mean age was 60.14 ±15.3. The majority of participants are males 64.8% ( n=70), and 34.3% (n=37) are of university level. out of diabetic complications, most are hypertensive. Patients were found to have good knowledge responses, some were with positive attitudes, and all were with bad practices. As for correlations, no statistically significant result was found in the knowledge section. Several factors were found with a positive relation in the attitude section as level of education and type of occupation. Lastly, also positive correlations were found in practices between several factors as duration of diabetes, occupation, and marital status with p-values \u0026lt;0.05.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e The study concludes that there is much more to learn and educate. Participants are aware of the dangers but do not follow proper health care services to prevent complications. Overall, the integration of both data sets reveals a multifaceted perspective among respondents, emphasizing the importance of tailored education, support, and interventions to promote adherence to foot care routines and optimize diabetes management outcomes.\u003c/p\u003e","manuscriptTitle":"Knowledge, attitudes, and practices of Footcare in Diabetic patients in Hammoud University Medical Center","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-27 02:11:20","doi":"10.21203/rs.3.rs-4165910/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"08942b7d-de87-4287-8811-a9c4fddb4047","owner":[],"postedDate":"March 27th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-04-02T10:05:16+00:00","versionOfRecord":[],"versionCreatedAt":"2024-03-27 02:11:20","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4165910","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4165910","identity":"rs-4165910","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}