Social Determinants of Health and Clinical Factors Associated with Diabetic Foot

Abstract

Introduction: Diabetic foot is one of the most frequent complications occurring in individuals with diabetes mellitus. This complication is characterized by infection, ulceration, ischemia, and destruction of soft tissues, associated with neurological losses and peripheral arterial disease (PAD). These conditions cause nerve sensitivity and vascular vulnerability, putting the patient at risk of serious complications. Objective: In this sense, this study aimed to describe the sociodemographic profile of patients, associate the social determinants of health with the disease, and propose a care protocol. Methodology: This is an integrative literature review that included articles in Portuguese, English, and Spanish published between 2020 and 2024 in the LILACS, SciELO, and BVS databases. The titles and abstracts of the studies were examined to identify those that met the established inclusion criteria. The data were entered into an Excel spreadsheet. Fifty-nine articles were included in the review. Wagner's classification was used to assess the degree of foot lesions, with grade 1 being the most prevalent. Results: A negative correlation was observed between diabetic foot and factors such as age over 60, low education, difficulty in accessing health services, harmful habits such as smoking and physical inactivity, low income, and lack of social support. Furthermore, both women and men are affected, but women seek health services at the onset of the disease and men in advanced stages. Conclusion: Sociodemographic factors and social determinants, such as age, education, lifestyle, and access to health services, directly influence the development and management of diabetic foot complications, requiring comprehensive care and prevention.