Summary: In a randomised trial in urban India, training patients with diabetes together with their family members improved foot-care knowledge and practice and family support, and no foot ulcers occurred in the intervention group versus 8% in controls over nine months.
PICO Summary
| Element | Detail |
|---|---|
| Population | 108 adults (18–60 years) with diabetes (54 per group) plus 2 family members each, in urban primary care; RCT, Jodhpur, India. |
| Intervention | Family-centred training and counselling on foot inspection, hygiene, footwear, and warning signs (patient plus family). |
| Comparison | Standard diabetes follow-up without structured family-centred foot education. |
| Outcome | At 9 months the intervention group had higher foot-care knowledge (13.4 vs 9.9) and practice scores (7.9 vs 6.2), both p<0.001, and higher family knowledge (12.2 vs 7.4). Perceived and actual family support rose. No foot ulcers occurred in the intervention group versus 4 (8%) in controls. |
Family-centred foot-care training in diabetes
RCT · type 2 diabetes · 9 months
Training patients with their family raised foot-care knowledge and practice, and no ulcers occurred in the intervention group versus 8% in controls over nine months. An encouraging signal from a small single-centre trial.
Expert Commentary
This is a thoughtful, contextually apt trial that addresses the real gap in foot-care prevention, which is rarely knowledge alone and more often the failure to sustain daily practice. Its central idea, recruiting family members as active partners, is sensible because relatives can perform the inspections patients with poor vision or limited mobility cannot, provide reminders, and create accountability, and the data show improvements in both knowledge and practice rather than awareness alone, which is the harder and more meaningful endpoint. The intervention is low-cost and feasible in exactly the resource-limited primary-care setting where most diabetic foot disease is managed and where amputation is too common. I would read the headline ulcer result, zero versus four cases, as an encouraging signal rather than firm proof, since it rests on small absolute numbers over nine months at a single centre, and the knowledge and practice scores were self-reported with the usual social-desirability risk. Can I use this with my patients? Yes, readily and at no real cost. It reinforces inviting a spouse or adult child into foot-care education, especially for patients with sensory or visual limitations, as a practical way to convert knowledge into sustained protective behaviour.
References
Radhakrishnan RV, Thirunavukkarasu P, Raghav P, Goel AD. Family-centered training and counselling for enhancing foot self-care knowledge and practices towards prevention of diabetes foot – a randomized controlled trial in urban Jodhpur. BMC Public Health. 2025;25(1):3323. doi:10.1186/s12889-025-24652-6