The objective was 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.

Methods

The National Health and Nutrition Examination Survey (NHANES) for the years 2011 to 2018 were analyzed. Participants (aged ³ 20) with diabetes were categorized into white, Black, Hispanic, Asian, and others (including multiracial) based on self-reported race and ethnicity. The primary outcome was foot examination over the past year by medical professional. Logistic regression was performed to examine the effects of race/ethnicity on annual diabetic foot examination, controlling for age (>65 years), gender, and health insurance status.

Results

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 at least one annual diabetic foot examination. Hispanics (OR 0.685, 95% CI 0.52-0.90) were significantly less likely than whites to receive annual examination (Blacks: OR 1.113, 95% CI 0.83-1.49; Asian: OR 0.798, 95% CI 0.60-1.07; Others: OR 0.661, 95% CI 0.40-1.10). Other factors associated with annual examination were age > 65 (OR 1.421, 95% 1.05-1.92) and health insurance (OR 3.02, 95% CI 2.66-4.03).

Conclusions

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 reflects the need to further identify factors driving the disparities in preventive diabetic foot care services among minority groups.