Prevalence, Risk Factors, and Psychological Impact of Amputations and Charcot Foot in Diabetic Patients: A Libyan Cross-Sectional Study

Aisha Elansari; Abulgasem Dakhil; Wasim Khalifa; Nadra Elalem; Fardous Altaweel; Abdulhakim Alfirjani; Alaa Alshawish; Zuhour Maruwan; Hadeel Alqamati

doi:10.54361/ajmas.258371

Authors

Aisha Elansari Department of Anesthesia and Intensive Care, Faculty of Medical Technology, The University of Tripoli, Libya https://orcid.org/0000-0001-7184-0486
Abulgasem Dakhil Department of Anesthesia and Intensive Care, Faculty of Medical Technology, The University of Tripoli, Libya https://orcid.org/0009-0003-0404-2531
Wasim Khalifa Department of Anesthesia and Intensive Care, Faculty of Medical Technology, The University of Tripoli, Libya https://orcid.org/0000-0002-8059-2506
Nadra Elalem Department of Anesthesia and Intensive Care, Faculty of Medical Technology, The University of Tripoli, Libya https://orcid.org/0009-0007-0561-8458
Fardous Altaweel Department of Anesthesia and Intensive Care, Faculty of Medical Technology, The University of Tripoli, Libya https://orcid.org/0000-0002-3827-5128
Abdulhakim Alfirjani Department of Anesthesia and Intensive Care, Faculty of Medical Technology, The University of Tripoli, Libya https://orcid.org/0000-0001-7140-7279
Alaa Alshawish Department of Anesthesia and Intensive Care, Faculty of Medical Technology, The University of Tripoli, Libya https://orcid.org/0009-0001-5403-114X
Zuhour Maruwan Department of Anesthesia and Intensive Care, Faculty of Medical Technology, The University of Tripoli, Libya https://orcid.org/0000-0002-6577-7668
Hadeel Alqamati Department of Anesthesia and Intensive Care, Faculty of Medical Technology, The University of Tripoli, Libya https://orcid.org/0000-0003-3432-9675

DOI:

https://doi.org/10.54361/ajmas.258371

Keywords:

Lower Extremity Amputation, Charcot Neuroarthropathy, Diabetic Foot Disease, Psychosocial Impact, Libya

Abstract

Diabetic foot complications impose a severe burden in resource-limited settings, yet comprehensive data from Libya remains scarce. This study assessed the prevalence of lower extremity amputations (LEA) and Charcot neuroarthropathy (CN), their risk factors, and psychological impact among diabetic patients in Tripoli, Libya. A cross-sectional study was conducted across five major healthcare facilities (October 2024–April 2025). A convenience sample of 149 adults with diabetes completed a structured 26-item questionnaire capturing demographics, clinical profiles, foot care practices, comorbidities, and psychosocial effects. Data were analyzed using descriptive statistics, Chi-square tests using SPSS version 26. The prevalence of LEA was 52% (n=78), with significant male predominance (55% vs. 45%, p<0.05). CN was identified in 19% (n=28). Hypertension (41%) was the leading comorbidity and significantly associated with amputation (p<0.05). Foot ulcers/infections were the primary amputation etiology (44%, p<0.001), predominantly requiring transmetatarsal procedures (37%). Key modifiable risk factors included inadequate foot hygiene (irregular inter-toe drying: χ²=38.645, p<0.001), non-therapeutic footwear (χ²=65.801, p<0.001), prolonged standing (49%, p<0.05), and smoking (χ²=21.955, p<0.001). Amputation caused severe psychosocial disruption: 64% reported impaired social life and 68% professional limitations (p<0.001). LEA and CN represent critical public health challenges in Libya, driven by modifiable behaviors and occupational exposures. The profound psychosocial burden underscores the urgent need for culturally adapted foot protection programs integrating education, therapeutic footwear, occupational adjustments, and psychological support.