{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:03:42Z","timestamp":1789621422420,"version":"build-2803163510"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetic foot complications are a major cause of morbidity, disability, and amputation worldwide, yet many complications are preventable through effective self-care. Limited evidence is available on foot self-care knowledge and behaviours among adults with diabetes in Ras Al Khaimah, United Arab Emirates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to assess foot self-care knowledge and behaviours and identify factors associated with these outcomes among adults with diabetes mellitus in Ras Al Khaimah.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted among 384 adults with diabetes attending selected primary healthcare centres and the Diabetes Centre at Ibrahim Bin Obaidullah Hospital in Ras Al Khaimah. Participants were selected using convenience sampling. Data were collected using a structured validated questionnaire comprising an eight-item knowledge scale and the 29-item Nottingham Assessment of Functional Foot Care. Data were analysed using SPSS version 22. Descriptive statistics, chi-square tests, multivariable logistic and linear regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most participants had poor foot-care knowledge (77.3%). Regarding foot self-care behaviours, 69.3% reported moderate behaviour, 26.0% poor behaviour, and 4.7% good behaviour. Knowledge category was significantly associated with foot self-care behaviour category (\u03c7\u00b2 = 9.784, p = 0.008; Cramer\u2019s V\u00a0=\u00a00.160). In multivariable logistic regression, females had lower odds of good knowledge than males (AOR\u00a0=\u00a00.45, 95% CI: 0.23\u20130.90, p = 0.023), and participants with type 2 diabetes had lower odds of good knowledge than those with type 1 diabetes (AOR\u00a0=\u00a00.43, 95% CI: 0.21\u20130.87, p = 0.020). In multivariable linear regression, female gender (B\u00a0=\u00a03.80, 95% CI: 1.99\u20135.61, p &amp;lt; 0.001), family history of diabetes (B\u00a0=\u00a01.89, 95% CI: 0.30\u20133.48, p = 0.020), and knowledge category (B\u00a0=\u00a01.83, 95% CI: 0.07\u20133.60, p = 0.041) were positively associated with foot self-care behaviour scores, while educational status (B = \u22121.57, 95% CI: \u22122.64 to \u22120.51, p = 0.004) and history of foot ulcer (B = \u22125.60, 95% CI: \u22127.81 to \u22123.38, p &amp;lt; 0.001) were negatively associated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Gaps were identified in foot-care knowledge and self-care behaviours among participants. Factors associated with knowledge and foot self-care behaviours should be considered when developing targeted foot-care education and support for adults with diabetes in primary and secondary healthcare settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1930648","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T04:29:26Z","timestamp":1789619366000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Foot self-care knowledge and behaviors among adults with diabetes mellitus: a cross-sectional survey in Ras Al Khaimah, United Arab Emirates"],"prefix":"10.3389","volume":"17","author":[{"given":"Rose Ekama","family":"Ilesanmi","sequence":"first","affiliation":[{"name":"RAK College of Nursing, RAK Medical and Health Sciences University","place":["Ras Al Khaimah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabab","family":"Gad Abd El-Kader","sequence":"additional","affiliation":[{"name":"RAK College of Nursing, RAK Medical and Health Sciences University","place":["Ras Al Khaimah, United Arab Emirates"]},{"name":"Faculty of Nursing, Mansoura University","place":["Mansoura, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasha","family":"Babiker","sequence":"additional","affiliation":[{"name":"RAK College of Medicine, RAK Medical and Health Sciences University","place":["Ras Al Khaimah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramya","family":"Kundayi Ravi","sequence":"additional","affiliation":[{"name":"RAK College of Nursing, RAK Medical and Health Sciences University","place":["Ras Al Khaimah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Anas Patni","sequence":"additional","affiliation":[{"name":"RAK College of Medicine, RAK Medical and Health Sciences University","place":["Ras Al Khaimah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled Walid","family":"Elayyan","sequence":"additional","affiliation":[{"name":"RAK College of Medicine, RAK Medical and Health Sciences University","place":["Ras Al Khaimah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meerah Ahmed","family":"Al-Ansi","sequence":"additional","affiliation":[{"name":"RAK College of Nursing, RAK Medical and Health Sciences University","place":["Ras Al Khaimah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Unique Great","family":"Efemu","sequence":"additional","affiliation":[{"name":"RAK College of Pharmacy, RAK Medical and Health Sciences University","place":["Ras Al Khaimah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulla Hussain","family":"Karam","sequence":"additional","affiliation":[{"name":"RAK College of Medicine, RAK Medical and Health Sciences University","place":["Ras Al Khaimah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebrahim Ahmed","family":"Alshuweihi","sequence":"additional","affiliation":[{"name":"RAK College of Medicine, RAK Medical and Health Sciences University","place":["Ras Al Khaimah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belal Mohammed","family":"Alsalem","sequence":"additional","affiliation":[{"name":"RAK College of Medicine, RAK Medical and Health Sciences University","place":["Ras Al Khaimah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeshina H.","family":"Adeniran","sequence":"additional","affiliation":[{"name":"Ras Al Khaimah Health Centre, Emirates Health Services","place":["Ras Al Khaimah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rawya Ahmed","family":"Alshehi","sequence":"additional","affiliation":[{"name":"Diabetes Centre, Ibrahim Bin Hamad Obaidullah Hospital, Emirates Health Services","place":["Ras Al Khaimah, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.109119","article-title":"IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045","volume":"183","author":"Sun","year":"2022","journal-title":"Diabetes Res Clin Pract"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.33448\/rsd-v14i7.49222","article-title":"Carga global das \u00falceras do p\u00e9 diab\u00e9tico: uma revis\u00e3o sistem\u00e1tica sobre preval\u00eancia, mortalidade e impacto cl\u00ednico-econ\u00f4mico","volume":"14","author":"Santos","year":"2025","journal-title":"Research Soc Dev"},{"key":"B3","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1186\/s12902-022-01044-0","article-title":"Preventive foot self-care practice and associated factors among diabetic patients attending the university of Gondar comprehensive specialized referral hospital, Northwest Ethiopia, 2021","volume":"22","author":"Mekonen","year":"2022","journal-title":"BMC Endocr Disord"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.2147\/JMDH.S447450","article-title":"Current perspectives, practices, and barriers faced by community pharmacists regarding pharmaceutical care services for diabetes mellitus in the United Arab Emirates","volume":"17","author":"Jairoun","year":"2024","journal-title":"J Multidiscip Healthc"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3657","article-title":"Practical guidelines on the prevention and management of diabetes\u2010related foot disease (IWGDF 2023 update)","volume":"40","author":"Schaper","year":"2024","journal-title":"Diabetes Metab Res Rev"},{"key":"B6","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1186\/s12912-026-04396-3","article-title":"A nurse-led self-efficacy\u2013based hybrid diabetic foot self-management education program for individuals with diabetes: a randomized controlled trial","volume":"25","author":"\u00c7elik Polat","year":"2026","journal-title":"BMC Nurs"},{"key":"B7","doi-asserted-by":"publisher","first-page":"33","DOI":"10.21315\/mjms2024.31.1.3","article-title":"A review of patient\u2019s knowledge and practice of diabetic foot self-care","volume":"31","author":"Untari","year":"2024","journal-title":"Malaysian J Med Sci"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12131244","article-title":"Knowledge and practice of foot care among patients with diabetes attending diabetes center, Saudi Arabia","volume":"12","author":"Aljaouni","year":"2024","journal-title":"Healthcare"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.47310\/jpms2025140822","article-title":"Knowledge and awareness level of the diabetic foot among diabetic patients in Saudi Arabia: a cross-sectional study","volume":"14","author":"Algamdi","year":"2025","journal-title":"J Pioneering Med Sci"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01301-6","article-title":"Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021","volume":"402","author":"Ong","year":"2023","journal-title":"Lancet"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-020-00383-2","article-title":"Five year mortality and direct costs of care for people with diabetic foot complications are comparable to cancer","volume":"13","author":"Armstrong","year":"2020","journal-title":"J Foot Ankle Res"},{"key":"B12","unstructured":"Statulator: An Online Statistical Calculator. Sample Size Calculator for Estimating a Single Proportion\n          \n          \n            \n              Dhand\n              NK\n            \n            \n              Khatkar\n              MS\n            \n          \n          \n          2014"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/pdi.1099","article-title":"Validation of a new measure of protective footcare behaviour: the Nottingham Assessment of Functional Footcare (NAFF)","volume":"24","author":"Lincoln","year":"2007","journal-title":"Pract Diabetes Int"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsps.2021.04.006","article-title":"Knowledge and practice of foot self-care among patients with diabetes attending primary healthcare centres in Kuwait: a cross-sectional study","volume":"29","author":"Alsaleh","year":"2021","journal-title":"Saudi Pharm J"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.18203\/2394-6040.ijcmph20185221","article-title":"Diabetic foot self-care: awareness and practice among type 2 diabetic patients in primary healthcare centers, Dubai Health Authority","volume":"6","author":"Mehmood","year":"2018","journal-title":"Int J Community Med Public Health"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.5530\/ijmedph.2019.4.32","article-title":"Knowledge and practice regarding foot care in patients with diabetes mellitus attending diabetic clinics in health centers in the Kingdom of Bahrain","volume":"9","author":"Habbash","year":"2019","journal-title":"Int J Med Public Health"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S171526","article-title":"Prevalence of diabetic comorbidities and knowledge and practices of foot care among diabetic patients: a cross-sectional study","volume":"11","author":"Abdulghani","year":"2018","journal-title":"Diabetes Metab Syndr Obes"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.15493","article-title":"Prevalence and determinants of peripheral neuropathy among adult type II diabetes mellitus patients attending a non-communicable disease clinic in rural South India","volume":"13","author":"Mathiyalagen","year":"2021","journal-title":"Cureus"},{"key":"B19","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1186\/s12875-026-03277-7","article-title":"Effect of health education on foot care knowledge and practice of patients with type 2 diabetes in rural Bangladesh","volume":"27","author":"Raquib","year":"2026","journal-title":"BMC Primary Care"},{"key":"B20","doi-asserted-by":"publisher","first-page":"59","DOI":"10.29121\/granthaalayah.v9.i8.2021.4159","article-title":"Diabetic foot care knowledge and its associated factors among type 2 diabetes patients","volume":"9","author":"Gomathi","year":"2021","journal-title":"Int J Res -GRANTHAALAYAH"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1177\/109019818801500203","article-title":"Social learning theory and the health belief model","volume":"15","author":"Rosenstock","year":"1988","journal-title":"Health Educ Q"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1177\/1090198104263660","article-title":"Health promotion by social cognitive means","volume":"31","author":"Bandura","year":"2004","journal-title":"Health Educ Behav"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_183_21","article-title":"Foot care knowledge, attitude and practices of diabetic patients","volume":"11","author":"Alharbi","year":"2022","journal-title":"J Family Med Prim Care"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1930648\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T04:29:29Z","timestamp":1789619369000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1930648\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":23,"alternative-id":["10.3389\/fendo.2026.1930648"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1930648","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]},"article-number":"1930648"}}