1466-P: Foot Care Education and Self-Efficacy Practices among Diabetic Patients in Developing Countries: A Cross-Country Survey

Introduction and Objective: Diabetic foot ulcers (DFUs) are a major complication among people with diabetes, particularly in developing countries, and are associated with high morbidity and mortality within the first five years of ulcer onset. This study aimed to assess foot care education, self-efficacy practices, and foot care behaviors among diabetic patients in Nigeria and Trinidad and Tobago. Methods: A cross-sectional questionnaire survey was conducted among diabetic patients attending routine clinic appointments in Nigeria (n=300) and Trinidad and Tobago (n=265). A validated questionnaire assessing foot care knowledge, self-efficacy, and behavior was adapted and administered. The SPSS software was employed for analysis of responses using binary and Likert-scale metrics, and t-tests and Chi-square tests for group comparisons. Results: Diabetes duration exceeded five years in 85% of the participants, and the prevalence of DFUs was significantly higher among Nigerian patients (p<0.001). Overall, 38% of patients had never received foot care education, with a higher proportion in Trinidad (55.5% vs. 22.3%, p<0.001). Nearly half (46.3%) of respondents did not know their HbA1c levels. While 80% demonstrated average self-confidence scores, patients from Trinidad reported significantly higher scores (all p<0.05). Appropriate foot care practices were performed only occasionally by most participants, particularly in Trinidad (all p<0.05). Conclusion: The high prevalence of DFUs, limited exposure to foot-care education, and moderate self-efficacy levels observed in these populations are associated with limb amputations. Thus, strengthening foot-care education as a central component of diabetes management could enhance self-efficacy and reduce the incidence of preventable lower-limb amputations in both settings. Disclosure C. Ezenwaka: None. Funding The University of the West Indies Research and Publication Fund grant number CRP.3.NOV24.01 and by JST SPRING Grant Number JPMJSP2125.