RISK ASSESSMENT OF FOOT ULCERS AMONG DIABETIC PATIENTS AT THE DIABETIC CENTER, AL QURAYYAT GENERAL HOSPITAL: A CROSS-SECTIONAL STUDY

Abstract

Risk Assessment Of Foot Ulcers Among Diabetic Patients At The Diabetic Center, Al Qurayyat General Hospital: A Cross-Sectional Study By Naif Shayish Alsharari

Supervisor Dr. Eman A Hammad, Prof. Abstract Aim of the study: This study is aimed to stratify diabetic patients into four risk groups for diabetic foot ulcer (DFU), to assess risk factors of DFU according to the International Working Group on the Diabetic Foot (IWGDF) classification, and to identify clinical, behavioral, and self-care predictors associated with higher DFU risk among adult patients with diabetes. Methods: A prospective cross-sectional study was conducted at the specialized endocrinology and diabetes center in Al-Qurayyat general hospital, Al-Jawf, Saudi Arabia, between August and October 2025. Adult patients (≥18 years) with type 1 or type 2 diabetes mellitus were recruited. Data were collected through face-to-face interviews, medical record review, and standardized questions. DFU risk groups from group 0 to group 3 were assessed using IWGDF criteria. Self-care activities were evaluated using the Arabic version of the Summary of Diabetes Self-Care Activities (SDSCA), medication adherence using the Morisky Green Levine scale, and quality of life using the Arabic EQ-5D-5L. Multinomial logistic regression was used to identify independent predictors for higher DFU risk groups. Results: A total of 253 patients were included, with a mean age of 55.8 ± 13.4 years; 59.7% were male and 98% had type 2 diabetes. Most participants were classified as low risk for DFU (Group 0: 75.5%), while 20.5% fell into higher risk groups (Groups 2 and 3). The mean HbA1c was 8.08 ± 1.50%, indicating poor glycemic control. Multinomial regression analysis revealed that the presence of athlete’s foot (OR = 10.33, p = 0.017) and peripheral arterial disease were strongly associated with higher DFU risk, while better self-care practices related to healthy diet (OR = 0.21, p = 0.011) and foot care (OR = 0.22, p = 0.002) were protective factors. Medication adherence and overall quality of life were not significantly associated with DFU risk categories. Conclusion: Although most patients were classified as low risk for DFU, a considerable proportion (20.5%) exhibited moderate to high risk. Foot-related conditions and inadequate self-care practices related to healthy diet and foot care were key predictors of higher DFU risk. Strengthening patient education and improving self-care behaviors, particularly diet and foot care, may play a crucial role in reducing DFU risk among patients with diabetes.