Misconceptions and health-seeking behavior among diabetic patients regarding foot ulcers: the hidden role of circulatory awareness in preventing amputation.

Authors

Abdulaziz Fahd AlKaabba, Yazeed AlHarbi, Fayez Zaben Al-Mutairi, Fawaz Sulaiman Alshaya, Omer Fahd Bin Jassas, Faris Saleh Alkahtani, Mohammed Abdullah Al-Subaie, Faisal Mohammed Alaswad, Abdulrahman AlOtaibi, Abdulrahman Omar Almesned, Rahaf Naji Almutairi

Published in

Frontiers in public health. Volume 14. Pages 1924054. Epub Sep 11, 2026.

Abstract

Diabetic foot ulcers (DFUs) are a leading cause of preventable amputation worldwide. Patient misconceptions and poor circulatory awareness are underrecognized drivers of delayed presentation in Saudi Arabia. This study aimed to assess DFU-related misconceptions, circulatory awareness, and health-seeking behavior, and identify predictors of delayed care-seeking.
A cross-sectional study was conducted between February and April 2026 among 574 adult diabetic patients attending 11 outpatient facilities in Riyadh, Saudi Arabia. A validated structured questionnaire assessed misconceptions, circulation awareness, health-seeking behavior, and prior education sources. Descriptive statistics, t-tests, ANOVA, chi-square, Pearson correlation, and binary logistic regression were applied; significance was set at p < 0.05.
The mean misconception score was 3.04 ± 0.34 (scale 1-5); 55.6% indicated a wound warrants attention only when painful, 65.0% stated they would delay care for a painless blister, and 50.7% would wait for pain before treating a painless ulcer. Circulation awareness averaged 3.25 ± 0.38; only 28.4% adequately distinguished nerve damage from circulatory impairment. Only 45.6% had received structured foot care education, while internet or social media (61.9%) outranked healthcare providers (35.9%) as the primary information source. Male sex (OR = 1.536, 95% CI 1.092-2.161, p = 0.014) and longer diabetes duration (OR = 1.258, 95% CI 1.049-1.509, p = 0.014) were the only independent predictors of high delay propensity.
Saudi diabetic patients demonstrated substantial DFU misconceptions and delay propensity, with pain-centric beliefs and inadequate formal education as key contributing factors. Structured, circulation-focused patient education within primary and family medicine settings may help address delayed presentation and support amputation prevention efforts.

PMID:
42798449
Bibliographic data and abstract were imported from PubMed on 26 Sep 2026.

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