ArticleFrontiers in endocrinology2026
Foot self-care knowledge and behaviors among adults with diabetes mellitus: a cross-sectional survey in Ras Al Khaimah, United Arab Emirates.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Diabetic foot complications are a major cause of morbidity, disability, and amputation worldwide, yet many complications are preventable through effective self-care. Limited evidence is available on foot self-care knowledge and behaviours among adults with diabetes in Ras Al Khaimah, United Arab Emirates. Aim: This study aimed to assess foot self-care knowledge and behaviours and identify factors associated with these outcomes among adults with diabetes mellitus in Ras Al Khaimah. Methods: A cross-sectional study was conducted among 384 adults with diabetes attending selected primary healthcare centres and the Diabetes Centre at Ibrahim Bin Obaidullah Hospital in Ras Al Khaimah. Participants were selected using convenience sampling. Data were collected using a structured validated questionnaire comprising an eight-item knowledge scale and the 29-item Nottingham Assessment of Functional Foot Care. Data were analysed using SPSS version 22. Descriptive statistics, chi-square tests, multivariable logistic and linear regression analyses. Results: Most participants had poor foot-care knowledge (77.3%). Regarding foot self-care behaviours, 69.3% reported moderate behaviour, 26.0% poor behaviour, and 4.7% good behaviour. Knowledge category was significantly associated with foot self-care behaviour category (χ² = 9.784, p = 0.008; Cramer's V = 0.160). In multivariable logistic regression, females had lower odds of good knowledge than males (AOR = 0.45, 95% CI: 0.23-0.90, p = 0.023), and participants with type 2 diabetes had lower odds of good knowledge than those with type 1 diabetes (AOR = 0.43, 95% CI: 0.21-0.87, p = 0.020). In multivariable linear regression, female gender (B = 3.80, 95% CI: 1.99-5.61, p < 0.001), family history of diabetes (B = 1.89, 95% CI: 0.30-3.48, p = 0.020), and knowledge category (B = 1.83, 95% CI: 0.07-3.60, p = 0.041) were positively associated with foot self-care behaviour scores, while educational status (B = -1.57, 95% CI: -2.64 to -0.51, p = 0.004) and history of foot ulcer (B = -5.60, 95% CI: -7.81 to -3.38, p < 0.001) were negatively associated. Discussion: Gaps were identified in foot-care knowledge and self-care behaviours among participants. Factors associated with knowledge and foot self-care behaviours should be considered when developing targeted foot-care education and support for adults with diabetes in primary and secondary healthcare settings.
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