Are diabetic patients adequately educated about their disease?

ABSTRACT
Objective: Diabetic foot ulcers (DFU) are among the most severe and costly complications of diabetes, significantly affecting patients’ quality of life and increasing the risk of hospitalization and amputation. This study aims to evaluate diabetic foot self-care behaviors and diabetes self-management skills in patients with DFUs.
Materials and Methods: This observational cross-sectional study was conducted with 228 patients diagnosed with DFUs who were admitted to the Underwater and Hyperbaric Medicine and Diabetic Foot Outpatient Clinics of a tertiary hospital. Patient demographic characteristics, clinical data, and wound-related variables were recorded. The Diabetes Self-Management Scale (DSMS) and Diabetic Foot Self-Care Behavior Scale (DFSBS) were administered via face-to-face interviews. Statistical analyses were performed using SPSS v25.0. P<0.05 was accepted as the statistical significance level.
Results: The mean age of participants was 63.1±10.5 years, and 72.4% were female. Among the patients, 55.3% had undergone diabetic foot surgery, and 38% had Wagner stage 4 wounds. The mean DSMS score was 6.6±1.7, and the median DFSBS score was 28.0 (IQR: 9.0). A significant positive relationship was found between education level and both DSMS and DFSBS subdimension scores (p<0.001). Dietary control scores were higher among patients who had undergone surgery and those with higher Wagner stages (p=0.019 and p=0.003, respectively). However, no significant correlation was observed between total DSMS or DFSBS scores and Wagner stage.
Conclusion: Improved self-care and self-management behaviors are associated with higher education levels and may be influenced by the severity of diabetic foot complications. Targeted educational interventions may enhance patient awareness, promote healthier behaviors, and potentially reduce DFU-related complications and healthcare costs. Further longitudinal studies are warranted to explore the direct impact of these behaviors on long-term outcomes and quality of life.
Keywords: Amputation, surgical, foot ulcer, self-care, nursing