Abstract
Objective: The main purpose of the study was to investigate the need for podiatrists as members of the
primary healthcare team. One of the objectives of the study was to determine the percentage of patients
presenting at the two Primary Healthcare clinics who are at risk of developing foot complications as a
result of an underlying concomitant systemic disease.
Research design and methods: A descriptive cross-sectional study in which data was collected from
patients presenting at two homogeneously selected Primary Healthcare (PHC) clinics in Johannesburg.
Nursing staff assisted by a final year podiatry student collected data using a self-constructed data
collection form (DCF) from each consenting patients as part of their routine patient consultation. Simple
descriptive statistics were used for data analysis.
Results: Data was collected and analysed from 1077 patients and showed that 29% of the patients had
diabetes. Diabetic foot ulceration risk factors that were recorded included peripheral neuropathy in 74%
of diabetic patients, structural foot deformities in 47%, peripheral vascular symptoms in 39% and foot
ulcer in 28% of the diabetic patients.
Conclusion: Early identification of diabetic patients who are at high risk of diabetic foot ulceration is
important and can be achieved via a mandatory diabetic foot screening with subsequent
multidisciplinary foot-care interventions. Understanding the factors that place patients with diabetes at
high risk of ulceration, together with an appreciation of the links between different aspects of the disease
process and foot function, is essential to the prevention and management of diabetic foot complications.
Significance of the study
• There is limited data available on diabetic foot risk factors across all levels of care in South
Africa.
• The study found that up to 74% of patients presenting at PHC facilities in this study had
symptoms of diabetic peripheral neuropathy and 28% had foot ulcers.
• The findings are suggestive of a need for diabetic foot assessment to be mandated at PHC
level as part of the routine diabetic patient assessment and for Podiatrists to be involved at
this level of care.