Main Article Content

shaheen akbar agha
ghazala usman
Muhammad Akbar Agha
shaikh hassan anwer
Rushna Khalid
Fouzia Raza
Sehrish Aleem


OBJECTIVE: to identify the socio-demographic factors and their association with health care awareness and practices of foot care among diabetic patients visiting the diabetic clinics of Jinnah postgraduate medical center (JPMC) and Civil Hospital, Karachi.
METHODOLOGY: This observational descriptive study was conducted at diabetic clinics of JPMC and civil hospital Karachi, from June to October, 2012 on a nonprobability convenience sample of 786 diabetics. The mean of the knowledge and practice scores of the individuals, categorized in respective age groups, gender and socioeconomic status, based on monthly income and education, were analyzed.
RESULT: Out of 786 diabetic patients, 356(45.3%) were females and 430(54.7%) were males; 395 (50.3%) had no primary education while 480 (61.1%) patients had low monthly income. There were 466 (59.3%) patients who were unaware of the fact that smoking causes poor circulation
of the feet and 357 (45.4%) patients were unaware about the temperature of water they should use to wash their feet in. Two hundred & forty two (30.8%) patients did not use warm water to wash their feet and 632 (80.4%) did not receive any health educational counseling about the type of footwear they should purchase and wear. However, 688
(87.5%) washed and 510 (64.9%) inspected their feet regularly. Poor education and low socio economic status were significantly associated with the lower awareness and practice scores.
CONCLUSION: Majority of the diabetics were not following the proper guidelines recommended by diabetic foot care counsels, especially those who were lacking education and of a low socioeconomic status.

Article Details

How to Cite
agha, shaheen, ghazala usman, M. Agha, shaikh anwer, R. Khalid, F. Raza, and S. Aleem. “INFLUENCE OF SOCIO DEMOGRAPHIC FACTORS ON KNOWLEDGE AND PRACTICE OF PROPER DIABETIC FOOT CARE”. KHYBER MEDICAL UNIVERSITY JOURNAL, Vol. 6, no. 1, Mar. 2014, pp. 9-13,
Original Articles
Author Biographies

shaheen akbar agha, Jinnah Sindh Medical University. Karachi

Professor & Head of Community Medicine Department

Jinnah Sindh Medical University

Muhammad Akbar Agha, Dow University of Health Sciences.Karachi

Professor of Pathology

Director Dr. Ishratul Ebad Khan Institute of Blood Diseases

Dow International Medical College

Dow University of Health Sciences. Karachi

shaikh hassan anwer, JSMU



Rushna Khalid



Fouzia Raza



Sehrish Aleem

student JSMU


1. Schwarz P, Schwarz J, Schuppenies A, Bornstein S, Schulze J. Development of a Diabetes Prevention Management Program for Clinical Practice. Public Health Rep 2007; 122(2): 258–63.

2. Stephan ND, Daryl KG. Insulin, oral hypoglycemic agents and the pharmacology of the endocrine pancreas. In: Hardman JG, Limbird LE, editors. Goodman and Gilman's The Pharmacological basis of Therapeutics. 10th ed. New York:McGraw - Hill; 2001. p. 1686-7.

3. Marshall S, Flyvbjerg A. Prevention and early detection of vascular complications of diabetes. Br Med J 2006; 333(7566): 475–80.

4. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993; 329: 977–86.

5. International Diabetes Federation [Internet]. Brussels,Belgium. IDF Diabetes Atlas-Fifth edition; 2012 [updated November 2012; cited 2013 March 1]. Available from:

6. Lavery LA, Armstrong DG, Wunderlich RP, Mohler MJ, Wendel CS, Lipsky BA. Risk factors for foot infections in individuals with diabetes. Diabetes Care 2006;29:1288-93.

7. Nelson EA, O’Meara S, Golder S, Dalton J, Craig D, Iglesias C; DASIDU Steering Group. Systematic review of antimicrobial treatments for diabetic foot ulcers. Diabet Med 2006; 23:348-59.

8. Shera AS, Jawad F, Maqsood A. Prevalence of diabetes in Pakistan. Diabetes Res Clin Pract 2007; 76:219-22.

9. Boulton AJ, Vileikyte L, Ragnarson-Tennvall G, Apelqvist J. The global burden of diabetic foot disease. Lancet 2005; 366: 1719–24.

10. Jeffcoate W, Bakker K. World diabetes day: footing the bill. Lancet 2005; 365: 1527.

11. Tesfaye S, Chaturvedi N, Eaton SE, Ward JD, Manes C, Ionescu-Tirgoviste C, et al. Vascular risk factors and diabetic neuropathy: EURODIAB Prospective Complications Study Group. N Engl J Med 2005; 352:341-50.

12. Daniel J. Macfarlane and Jeffrey L. Jensen. Factors in Diabetic Footwear Compliance. J Am Podiatr Med Assoc 2003; 93:485-91.

13. Viswanathan V, Madhavan S, Gnanasundaram S, Gopalakrishna G, Das BN, Rajasekar S, Ramachandran A. Effectiveness of different types of footwear insoles for the diabetic neuropathic foot: a follow-up study. Diabetes Care 2004; 27:474-7.

14. Hasnain S, Sheikh NH. Knowledge and practices regarding foot care in diabetic patients visiting diabetic clinic in Jinnah Hospital, Lahore. J Pak Med Assoc 2009; 59: 687-90.

15. Ali SM, Basit A, Sheikh T, Mumtaz S, Hydrie MZ. Diabetic foot ulcer--a prospective study. J Pak Med Assoc 2001; 51: 78-81.

16. Mayfield JA, Reiber GE, Sanders LJ, Janisse D, Pogach LM. Preventive foot care in people with diabetes. Diabetes Care. 1998; 21:2161–77.

17. Gondal M, Bano U, Moin S, Afridi Z, Masood R, Ahmed A. Evaluation of knowledge and practices of foot care in patients with chronic type 2 Diabetes Mellitus. J Postgrad Med Inst 2007; 21: 104-8.

18. Khamesh ME, Vatankhah N, Baradaran HR. Knowledge and practice of foot care in Iranian people with type 2 Diabetes. Int Wound J 2007; 4:298-302.

19. O Desalu, F K Salawu, A K Jimoh, A O Adekoya, O A Busari, A B Olokoba. Diabetic foot care: Self-reported knowledge and practice among patients attending three tertiary hospital in Nigeria. Ghana Med J 2011; 45(2):60-5.