TYPES AND GRADES OF FOOTWEAR AND FACTORS ASSOCIATED WITH POOR FOOTWEAR CHOICE AMONG DIABETIC PATIENTS IN USM HOSPITAL.

ABSTRACT Background: Diabetic foot ulcer (DFU) is a preventable yet debilitating complication that is frequently seen in diabetic patients. Footwear has been implicated as contributing towards the development of foot ulcers and is the initial step leading towards lower limb amputations. Materials and Methods: The objective of this study was to determine the types and grades of footwear worn by diabetics and factors associated with poor footwear choice. This cross-sectional study was conducted using an interviewer-administered questionnaire that included the Footwear Suitability Scale for Diabetics. 174 diabetics were recruited via systematic random sampling from three outpatient clinics in University Sains Malaysia (USM) Hospital, Kelantan, Malaysia. Results: It was seen that 71.3% of diabetics wore poor grade footwear. The most preferred type of footwear was open sandals without back support [66 (37.9%)], followed by open sandals with forking, closed shoes with laces or adjustable straps and closed shoes without laces or adjustable straps which was 23 (13.2%), 15 (8.6%) diabetics wore open sandals with back support and high heels respectively. The significant associated factors influencing poor footwear choice were sex and the presence of active DFU with OR: 6.85 (95% CI 2.95, 15.89), 0.99 (95% CI 0.98, 1.00) and 5.51 (95%CI 1.69, 17.95) respectively. Conclusion: This study was able to capture the prevalence of poor footwear choice among diabetics and understand the associated factors. It reinforces the need of effective intervention programs pertaining the importance of footwear as primary prevention of DFU’s. Keywords: Footwear, types, grades, associated factors, diabetics