Study: Disparities in Preventative Diabetic Foot Education ActAgainstAmputation #DiabeticFoot @ALPSlimb @VascularAZ @USC @USC_vascular @ResearchatUSC @KeckSchool_USC @TzeWoeiTan

This from our combined Arizona/USC SALSA Team.


The objective of this study is to assess the overall differences in the standard of preventive foot care for patients at risk of diabetic foot ulceration and to identify specific demographic factors affecting these healthcare practices including race and ethnicity.


The National Health and Nutrition Examination Survey (NHANES) data for the years 2011 to 2018 were analyzed. Participants (aged ≥ 20) with diabetes were categorized into White, Black, Hispanic, Asian, and others (including multiracial participants) based on self-reported race/ethnicity. The primary outcome was foot examination over the past year administered by a medical professional. Logistic regression was performed to examine the effects of race/ethnicity on the annual diabetic foot examination, controlling for age (≥ 65 years), gender, and health insurance.


Among the 2,836 participants included in the study (weighted percentage 61.1% Whites, 13.9% Blacks, 15.1% Hispanics, 5.4% Asians, and 4.5% others), 2,018 (weighted percentage 71.6%) received annual diabetic foot examination over the past year. Hispanics (aOR 0.685, 95% CI 0.52-0.90) were significantly less likely than Whites to receive annual foot examination (Blacks: aOR 1.11, 95% CI 0.83-1.49; Asian: aOR 0.80, 95% CI 0.60-1.07; Others: aOR 0.66, 95% CI 0.40-1.10). Factors associated with receipt of foot examination were age 65 years or older (aOR 1.42. 95% CI 1.05-1.92) and having health insurance (aOR 3.02, 95% CI 2.27-4.03).


Our findings suggest that Hispanics with diabetes are receiving disproportionately lower rates of preventive foot care as compared to their White counterparts. This significant variation in the standard of care for patients with diabetes reflects the need to further identify factors driving the disparities in preventive foot care services among minority groups.

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