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Abstract：
BACKGROUND: Evidence on the prevalence of foot problems among people with diabetes in India at a national level is lacking. Hence, this study was aimed to assess the burden of high-risk (HR) feet in people with diabetes across India.
METHODS: A cross-sectional national-level project \'Save the Feet and Keep Walking\' campaign was conducted by the Research Society for the Study of Diabetes in India (RSSDI) from July 10, 2022 to August 10, 2022. A modified version of 3 min foot examination was used to assess the foot problems. Around 10 000 doctors with RSSDI membership were trained online to conduct foot screening and provided a standardised monofilament for detection of loss of protective sensation. People with diabetes aged >18 years who visited the clinics during the study period were examined for foot problems. Data were collected online using the semi-structured questionnaire. A total of 33 259 participants with complete information were included for the final analysis. The foot at risk was categorised based on International Working Group on the Diabetic Foot guidelines 2023.
RESULTS: Nearly 75% of the participants were aged above 45 years. Around 49% had diabetes duration >5 years and uncontrolled diabetes (hemoglobin A1c >8%). Presence of history of foot ulcer (20%), lower limb amputation (15.3%), foot deformities (24.5%) and absence of diminished dorsal pedis and posterior tibial pulses (26.4%) was noted in the study participants. Around 25.2% of them had HR feet and highly prevalent among males. Diabetic kidney and retinal complications were present in 70% and 75.5% of people with HR feet. Presence of heel fissures (OR (95% CI) 4.6 (4.2 to 5.1)) and callus or corns (OR (95% CI) 3.6 (3.3 to 4.0)) were significantly associated with HR feet.
CONCLUSIONS: One-fourth of people with diabetes were found to have HR feet in India. The findings are suggestive of regular screening of people with diabetes for foot problems and strengthening of primary healthcare.
METHODS: A cross-sectional national-level project \'Save the Feet and Keep Walking\' campaign was conducted by the Research Society for the Study of Diabetes in India (RSSDI) from July 10, 2022 to August 10, 2022. A modified version of 3 min foot examination was used to assess the foot problems. Around 10 000 doctors with RSSDI membership were trained online to conduct foot screening and provided a standardised monofilament for detection of loss of protective sensation. People with diabetes aged >18 years who visited the clinics during the study period were examined for foot problems. Data were collected online using the semi-structured questionnaire. A total of 33 259 participants with complete information were included for the final analysis. The foot at risk was categorised based on International Working Group on the Diabetic Foot guidelines 2023.
RESULTS: Nearly 75% of the participants were aged above 45 years. Around 49% had diabetes duration >5 years and uncontrolled diabetes (hemoglobin A1c >8%). Presence of history of foot ulcer (20%), lower limb amputation (15.3%), foot deformities (24.5%) and absence of diminished dorsal pedis and posterior tibial pulses (26.4%) was noted in the study participants. Around 25.2% of them had HR feet and highly prevalent among males. Diabetic kidney and retinal complications were present in 70% and 75.5% of people with HR feet. Presence of heel fissures (OR (95% CI) 4.6 (4.2 to 5.1)) and callus or corns (OR (95% CI) 3.6 (3.3 to 4.0)) were significantly associated with HR feet.
CONCLUSIONS: One-fourth of people with diabetes were found to have HR feet in India. The findings are suggestive of regular screening of people with diabetes for foot problems and strengthening of primary healthcare.
摘要：
背景：在全国范围内，缺乏关于印度糖尿病患者足部问题患病率的证据。因此，这项研究旨在评估印度糖尿病患者高危(HR)足的负担.
方法：印度糖尿病研究学会（RSSDI）于2022年7月10日至2022年8月10日开展了一项横断面国家级项目“拯救脚并保持行走”活动。使用3分钟足部检查的修改版来评估足部问题。大约10,000名具有RSSDI会员资格的医生接受了在线培训，以进行足部筛查，并提供了标准化的单丝以检测保护性感觉的丧失。在研究期间到诊所就诊的年龄>18岁的糖尿病患者被检查足部问题。使用半结构化问卷在线收集数据。共有33259名具有完整信息的参与者被纳入最终分析。根据国际工作组对糖尿病足指南2023进行分类。
结果：近75%的参与者年龄在45岁以上。约49%的人患有糖尿病持续时间>5年和未控制的糖尿病(血红蛋白A1c>8%)。有足溃疡病史（20%），下肢截肢(15.3%),研究参与者发现足畸形(24.5%)和足背和胫骨后脉冲减少(26.4%).其中约有25.2％的人患有HR脚，在男性中非常普遍。70％和75.5％的HR足患者存在糖尿病肾脏和视网膜并发症。足跟裂痕（OR（95％CI）4.6（4.2至5.1））和愈伤组织或鸡眼（OR（95％CI）3.6（3.3至4.0））的存在与HR足明显相关。
结论：在印度，四分之一的糖尿病患者被发现有HR足。这些发现暗示了定期筛查糖尿病患者的足部问题和加强初级医疗保健。
方法：印度糖尿病研究学会（RSSDI）于2022年7月10日至2022年8月10日开展了一项横断面国家级项目“拯救脚并保持行走”活动。使用3分钟足部检查的修改版来评估足部问题。大约10,000名具有RSSDI会员资格的医生接受了在线培训，以进行足部筛查，并提供了标准化的单丝以检测保护性感觉的丧失。在研究期间到诊所就诊的年龄>18岁的糖尿病患者被检查足部问题。使用半结构化问卷在线收集数据。共有33259名具有完整信息的参与者被纳入最终分析。根据国际工作组对糖尿病足指南2023进行分类。
结果：近75%的参与者年龄在45岁以上。约49%的人患有糖尿病持续时间>5年和未控制的糖尿病(血红蛋白A1c>8%)。有足溃疡病史（20%），下肢截肢(15.3%),研究参与者发现足畸形(24.5%)和足背和胫骨后脉冲减少(26.4%).其中约有25.2％的人患有HR脚，在男性中非常普遍。70％和75.5％的HR足患者存在糖尿病肾脏和视网膜并发症。足跟裂痕（OR（95％CI）4.6（4.2至5.1））和愈伤组织或鸡眼（OR（95％CI）3.6（3.3至4.0））的存在与HR足明显相关。
结论：在印度，四分之一的糖尿病患者被发现有HR足。这些发现暗示了定期筛查糖尿病患者的足部问题和加强初级医疗保健。
