Diabetes-related lower-limb amputations account for 47% of all amputations in Oman, according to a systematic review published in the International Journal of Public Health Science in June. The authors, from Oman’s Ministry of Health in Muscat, Hai Al Jamee Health Center and Bousher Polyclinic, describe diabetic foot disease in Oman as preventable but growing rapidly, and say best practice in its management is under-reported.
What the review looked at
Saud Al Harthi, Thamra Al Ghafri, Nahal Afifi and Aisha Al Mehrazi searched PubMed, Scopus, the Cochrane Library, the WHO EMRO repository and Google Scholar, along with two Omani journal archives, for studies published up to March 2026. Two reviewers screened the records independently, and study quality was appraised with an adapted Newcastle-Ottawa scale. Ten publications met the inclusion criteria.
Rather than simply listing the findings, the team mapped them onto the COM-B model, which looks at the capability, opportunity and motivation behind a behaviour, so that each gap points towards a type of public health intervention.
Diabetic foot disease in Oman: the key numbers
- Amputations: 47% of all amputations nationally are diabetes-related lower-limb amputations.
- Capability: 55% of people studied did not know what causes diabetic foot disease.
- Opportunity: there are no multidisciplinary foot care teams outside Muscat, and 50–54% of participants reported walking barefoot.
- Motivation: only 38% carried out regular foot examinations.
The authors note that the evidence base on diabetic foot disease in Oman is thin. There are few interventional studies, most research comes from urban settings, and outcomes are largely self-reported.
What the authors recommend
To tackle diabetic foot disease in Oman, the review sets out three policy priorities: a national diabetic foot registry, multidisciplinary foot care extended beyond the capital, and behaviour change techniques built into primary care.
IMEA POD Perspective
The 47% figure is striking, but the more telling finding is geographic: outside Muscat there are no multidisciplinary foot teams. Patients in the interior and coastal governorates who develop an ulcer face long journeys to specialist care, often after the window for limb salvage has narrowed. High rates of barefoot walking and low rates of self-examination mean ulcers are both more likely and more likely to be missed. Oman’s well-developed primary care network is the obvious place to start. Routine foot screening, risk stratification and footwear advice can be delivered by trained nurses and foot care practitioners, with a clear referral route to a regional team. A national registry would let the Ministry measure whether those changes reduce amputations. Saudi Arabia’s Walk Safe programme shows Gulf health systems are starting to treat diabetic foot as a national priority, and the Bengaluru Declaration calls for exactly that. Oman now has the data to make the same case. What it lacks, like most of the region, is a podiatry workforce to deliver care outside the capital.
Sources and further reading
- Al Harthi S, Al Ghafri T, Afifi N, Al Mehrazi A. “Diabetic foot” in Oman: A systematic review and COM-B public health intervention framework. International Journal of Public Health Science 2026;15(2):573–582 (Zenodo record)
- DOI: 10.11591/ijphs.v15i2.27104
- IMEA POD: Saudi Arabia launches Walk Safe national diabetic foot programme
- IMEA POD: Bengaluru Declaration calls for diabetic foot to be a world health priority