Adults with diabetic foot complications attending Dubai’s public primary care clinics knew as much about foot care as those without complications, but practised it significantly less, according to a study in the Journal of the American Podiatric Medical Association (JAPMA).
The Dubai foot care study
Anne Matter, Abir Fahmy Mohamed, Ayesha Al Olama and Mai Haidar AwadAllah of the Dubai Health Authority (DHA), with Derek Santos of Queen Margaret University in Scotland, surveyed 268 adults with diabetes attending non-communicable disease clinics at DHA primary health care centres. Seventeen had diabetic foot complications and 251 did not. Participants completed a demographic survey and a knowledge, attitudes and practices (KAP) questionnaire with ten knowledge, eight practice and five attitude items. The paper was published on 20 February 2026.
Key findings
Patients with foot complications were older: 70.6% were over 60, compared with 41.8% of those without. They had higher HbA1c (p = 0.017) and were more likely to use insulin (p = 0.001) and herbal therapies (p = 0.003).
Knowledge and attitude scores did not differ significantly between the two groups. Practice scores, however, were significantly lower among those with complications (p < 0.001). Attending a foot care education programme was associated with better foot care practices (p = 0.013) and more positive attitudes. The authors conclude that targeted education is needed to close the gap between what patients know and what they do.
Reading the results carefully
Only 17 participants had foot complications, so comparisons between the groups should be treated with caution. Because the study is cross-sectional, it cannot show whether poor self-care led to complications or followed them. The paper is also inconsistent on one point: the abstract links education to better knowledge, while the results report the same p-value for attitudes.
IMEA POD Perspective
Knowing the rules but not following them is a pattern every podiatrist recognises, and this study puts Dubai data behind it. The message for Gulf foot teams is that leaflets and lectures are not enough. Education should be practical and repeated: checking the feet with a mirror, inspecting shoes before wearing them, and checking footwear at every visit. Where relatives or carers help with daily care, they should be trained too. Education also needs to address risks that are common in the Gulf, such as walking barefoot at home and in mosques and wearing open footwear in the heat. The higher use of herbal therapies among patients with complications is worth noting: clinicians should ask about it without judgement, since some remedies are applied directly to wounds. Older, insulin-treated patients with high HbA1c are the obvious group to prioritise for annual screening and structured education. The new Gulf-specific DFU guidelines give the region a common framework. Studies like this show where it needs to focus.
Sources and further reading
- Matter A, Mohamed AF, Al Olama A, AwadAllah MH, Santos D. Evaluating Foot Care Knowledge, Attitudes and Practices Among Diabetics in Dubai’s Primary Health Care Sector. JAPMA 2026;116(1):6
- IMEA POD: Gulf Diabetic Foot Working Group publishes first Gulf-specific DFU guidelines
- IWGDF Guidelines on the prevention and management of diabetes-related foot disease