Diabetic foot complications and their management at primary healthcare clinics in Johannesburg



diabetic foot, primary healthcare, South Africa, diabetic foot complication, diabetic foot risk management, diabetic foot risk factors


Background: Primary healthcare (PHC) in South Africa is predominantly nurse-driven, focusing on illness prevention and treatment of acute and chronic disorders. However, data on diabetic foot complications at PHC clinics is limited, and the role of podiatrists in prevention is underutilised. Diabetic foot complications, particularly ulcers, are a significant cause of amputations, with early identification and treatment crucial for prevention.

Methods: This cross-sectional retrospective study involved 536 diabetic patients with foot complications from three Johannesburg PHC  centres. Descriptive statistics were used to analyse patient data.

Results: The study reveals a high prevalence of diabetic foot complications in PHC clinics, emphasising the need for community foot health promotion and podiatrist involvement. Early intervention is crucial, especially in patients with longer diabetes duration. Inadequate management and screening of foot-related complaints by nurses are observed. Lack of guidelines and well-defined referral pathways contribute to inadequate diabetic foot management.

Conclusion: The study reveals significant challenges in managing diabetic foot complications in South Africa’s PHC system, emphasising the need for reform, early intervention, and the inclusion of podiatrists to provide holistic care and prevent amputations. The study concludes that podiatrists should be an integral part of PHC teams to improve diabetic foot care.

Author Biographies

YM Choonara, University of Johannesburg

University of Johannesburg, South Africa

S Ntuli, University of Johannesburg

University of Johannesburg, South Africa






Original Research