Foot and ankle survey in adults with diabetes mellitus

The purpose of this study was to examine the foot and ankle care patterns and shoe wear habits in patients with clinically proven diabetes mellitus who were attending diabetes education classes for the first time. One hundred subjects were recruited from outpatient adult diabetes education classes. No attempts were made to select patients on the basis of disease duration or severity. Each subject completed a questionnaire assessing life-style, shoe wear habits, health care status and interaction with healthcare providers. Thirty-seven percent of the subjects reported prior foot problems. Twenty percent had their feet examined regularly and 59% had never had their feet examined. Foot problems reported were: corns 11%, calluses 11%, bunions 3%, ulcers 1%, gout 1%. Sensation was tested using the 5.07 Semmes Weinstein monofilament across seven zones of the plantar surface of the foot. Subjects unable to feel this varied from 5% to 20% in each of the zones. Shoe wear was assessed for fit and style. Thirty percent of the patients had shoes that were too narrow and 81% of the patients with poorly fitting shoes were women. Shoe wear history and factors influencing shoe selection were recorded. Diabetes mellitus is a common disease, often affecting the feet. Preventive care can help patients deal with the manifestations of diabetic neuropathy. This study showed that a low percentage of subjects with diabetes regularly have their feet examined and that a relatively high percentage (31%) wear shoes that are too narrow. Identifying these patients early may allow modification of habits that put their feet at risk.