Seeing the Risk, Missing the Care: Foot Care Practices Among Patients with Diabetic Retinopathy in Coastal India
Sri Archana, Chethan B. Shetty, Atmananda S. Hegde, U. Keerthan Ranga NayakAbstract
Background and Aims:
Diabetic retinopathy (DR) and diabetic foot disease share a common microvascular etiology, yet foot care behavior in patients with DR is poorly characterized. We aimed to quantify foot care practices using a validated instrument and to identify independent predictors of adequate foot care.
Materials and Methods:
This was a cross-sectional study of 165 adults with confirmed DR attending a tertiary care center. Foot care behavior was assessed using the Revised Nottingham Assessment of Functional Footcare (NAFF-29; maximum score 87; satisfactory ≥50). Associations were tested by Chi-square, Kruskal–Wallis, and Spearman correlation, and multivariate binary logistic regression was used to identify independent predictors.
Results:
The mean NAFF-29 score was 45.47 ± 4.82 (52.3% of maximum). Foot care was suboptimal in 131 patients (79.4%) and satisfactory in only 34 (20.6%). Domain deficits were greatest for wound and blister care (25.8% of maximum) and foot hygiene and self-examination (37.9%). Retinopathy severity, glycemic control, and neuropathy did not predict foot care adequacy (all
Conclusion:
Nearly four in five patients with DR demonstrated suboptimal foot care. Health literacy, rather than disease burden, drives preventive behavior. The ophthalmology follow-up visit is an underutilized but high-yield platform for foot care screening and education in this high-risk group.