{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T15:59:32Z","timestamp":1793462372308,"version":"4.5.0"},"reference-count":42,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Diab Res Care"],"accepted":{"date-parts":[[2024,6,27]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Evidence on the prevalence of foot problems among people with diabetes in India at a national level is lacking. Hence, this study was aimed to assess the burden of high-risk (HR) feet in people with diabetes across India.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research design and methods<\/jats:title>\n                  <jats:p>A cross-sectional national-level project \u2018Save the Feet and Keep Walking\u2019 campaign was conducted by the Research Society for the Study of Diabetes in India (RSSDI) from July 10, 2022 to August 10, 2022. A modified version of 3\u2009min foot examination was used to assess the foot problems. Around 10\u2009000 doctors with RSSDI membership were trained online to conduct foot screening and provided a standardised monofilament for detection of loss of protective sensation. People with diabetes aged &gt;18\u2009years who visited the clinics during the study period were examined for foot problems. Data were collected online using the semi-structured questionnaire. A total of 33\u2009259 participants with complete information were included for the final analysis. The foot at risk was categorised based on International Working Group on the Diabetic Foot guidelines 2023.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Nearly 75% of the participants were aged above 45 years. Around 49% had diabetes duration &gt;5\u2009years and uncontrolled diabetes (hemoglobin A1c &gt;8%). Presence of history of foot ulcer (20%), lower limb amputation (15.3%), foot deformities (24.5%) and absence of diminished dorsal pedis and posterior tibial pulses (26.4%) was noted in the study participants. Around 25.2% of them had HR feet and highly prevalent among males. Diabetic kidney and retinal complications were present in 70% and 75.5% of people with HR feet. Presence of heel fissures (OR (95% CI) 4.6 (4.2 to 5.1)) and callus or corns (OR (95% CI) 3.6 (3.3 to 4.0)) were significantly associated with HR feet.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>One-fourth of people with diabetes were found to have HR feet in India. The findings are suggestive of regular screening of people with diabetes for foot problems and strengthening of primary healthcare.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjdrc-2024-004064","type":"journal-article","created":{"date-parts":[[2024,8,3]],"date-time":"2024-08-03T12:55:15Z","timestamp":1722689715000},"page":"e004064","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Early screening for foot problems in people with diabetes is the need of the hour: \u2018Save the Feet and Keep Walking Campaign\u2019 in India"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9116-3937","authenticated-orcid":false,"given":"Vijay","family":"Viswanathan","sequence":"first","affiliation":[{"name":"M V Hospital for Diabetes and Professor M Viswanathan Diabetes Research Centre, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Gupta","sequence":"additional","affiliation":[{"name":"Centre for Diabetes Care, Greater Noida, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arutselvi","family":"Devarajan","sequence":"additional","affiliation":[{"name":"M V Hospital for Diabetes and Professor M Viswanathan Diabetes Research Centre, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satyavani","family":"Kumpatla","sequence":"additional","affiliation":[{"name":"M V Hospital for Diabetes and Professor M Viswanathan Diabetes Research Centre, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharvari","family":"Shukla","sequence":"additional","affiliation":[{"name":"Symbiosis Statistical Institute, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Aegle Clinic\u2014Diabetes Care, Pune, Maharashtra, India"},{"name":"Department of Medicine & Diabetes, Ruby Hall Clinic, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brij Mohan","family":"Makkar","sequence":"additional","affiliation":[{"name":"Dr Makkar's Diabetes & Obesity Centre, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Banshi","family":"Saboo","sequence":"additional","affiliation":[{"name":"Diabetes Care and Hormone Clinic, Ahmedabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasanth","family":"Kumar","sequence":"additional","affiliation":[{"name":"Apollo Hospitals, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh Kumar","family":"Sahay","sequence":"additional","affiliation":[{"name":"Osmania Medical College, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,8,3]]},"reference":[{"key":"2025073112435523000_12.4.e004064.1","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1016\/S2213-8587(23)00119-5","article-title":"Metabolic non-communicable disease health report of india: the ICMR-INDIAB national cross-sectional study (ICMR-INDIAB-17)","volume":"11","author":"Anjana","year":"2023","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2025073112435523000_12.4.e004064.2","unstructured":"International Diabetes Federation . 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Diabetes-related peripheral Neuropathyand peripheral arterial disease. 2022."},{"key":"2025073112435523000_12.4.e004064.9","first-page":"102","article-title":"The costs of treating long-term diabetic complications in a developing country: a study from India","volume":"61","author":"Kumpatla","year":"2013","journal-title":"J Assoc Physicians India"},{"key":"2025073112435523000_12.4.e004064.10","doi-asserted-by":"crossref","first-page":"101909","DOI":"10.1016\/j.foot.2022.101909","article-title":"Health economics of diabetic foot ulcer and recent trends to accelerate treatment","volume":"52","author":"Jodheea-Jutton","year":"2022","journal-title":"Foot (Edinb)"},{"key":"2025073112435523000_12.4.e004064.11","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1080\/14737167.2017.1305891","article-title":"Losing a foot versus losing a dollar; a systematic review of cost studies in diabetic foot complications","volume":"17","author":"Petrakis","year":"2017","journal-title":"Expert Rev Pharmacoecon Outcomes Res"},{"key":"2025073112435523000_12.4.e004064.12","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.ando.2017.11.005","article-title":"Cost of diabetic foot in france, spain, italy, germany and united kingdom: a systematic review","volume":"79","author":"Tchero","year":"2018","journal-title":"Ann Endocrinol (Paris)"},{"key":"2025073112435523000_12.4.e004064.13","doi-asserted-by":"publisher","DOI":"10.4103\/2230-8210.126587"},{"key":"2025073112435523000_12.4.e004064.14","doi-asserted-by":"crossref","DOI":"10.1186\/s12902-020-0512-y","article-title":"Diabetic foot care: knowledge and practice","volume":"20","author":"Pourkazemi","year":"2020","journal-title":"BMC Endocr Disord"},{"key":"2025073112435523000_12.4.e004064.15","doi-asserted-by":"crossref","unstructured":"Abo deif H ibrahim , Abdelaziz SH . 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