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Preventive Foot-Care Practices Among Adults with Diabetes in North Carolina, 1997 to 2001

John C. White, DPM ^*, Ronny A. Bell, PhD, MS , Carl D. Langefeld, PhD  and Sharon A. Jackson, PhD 

^* Private practice, Winston-Salem, NC. Dr. White is now at the Virginia Health Quality Center, Glen Allen.
Section on Epidemiology, Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC.
Section on Biostatistics, Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC.

Corresponding author: Ronny A. Bell, PhD, MS, Section on Epidemiology, Department of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157.

Abstract

Preventive foot-care practices, such as annual foot examinations by a health-care provider, can substantially reduce the risk of lower-extremity amputations. We examined the level of preventive foot-care practices (reported rates of having at least one foot examination by a physician) among patients with diabetes mellitus in North Carolina and determined the factors associated with these practices. Of 1,245 adult respondents to the 1997 to 2001 North Carolina Behavioral Risk Factor Surveillance System, 71.6% reported that they had had their feet examined within the past year, a rate that is much higher than that previously reported by Bell and colleagues in the same population for 1994 to 1995 (61.7%). Foot care was more common among insulin users than nonusers, those having diabetes for 20 years or longer than those having diabetes for less than 10 years, blacks than whites, and those who self-monitored their blood glucose level daily than those who did not. The results of this study indicate that diabetes educational services can be directed at populations at high risk of ignoring the recommended foot-care practices indicated in these analyses, thereby reducing diabetes-related lower-extremity complications. (J Am Podiatr Med Assoc 94(5): 483–491, 2004)