Background: Diabetic foot ulcers (DFUs) are a major complication among people with diabetes, particularly in developing countries, and are associated with high morbidity and mortality within the first five years of ulcer onset.

Aim: This study aimed to assess foot care education, self-efficacy practices, and foot care behaviors among diabetic patients in Nigeria and Trinidad and Tobago.

Methods: A cross-sectional questionnaire survey was conducted among 565 diabetic patients attending routine clinic appointments in Nigeria and Trinidad and Tobago. A validated questionnaire assessing foot care knowledge, self-efficacy, and behavior was adapted and administered. The Statistical Package for the Social Sciences (SPSS) software was employed for analysis of responses using binary and Likert-scale metrics while Student t-tests and Chi-square tests were used to compare groups.

Results: Diabetes duration exceeded five years in 85% of the participants, and the prevalence of DFUs was significantly higher among Nigerian patients (p<0.001). Overall, 38% of patients had never received foot care education, with a higher proportion in Trinidad (55.5% vs. 22.3%, p<0.001). Nearly half (46.3%) of respondents did not know their HbA1c levels. While 80% demonstrated average self-confidence scores, patients from Trinidad reported significantly higher scores (all p<0.05). Appropriate foot care practices were performed only occasionally by most participants, particularly in Trinidad (all p<0.05).

Conclusion and Recommendation: The high prevalence of DFUs, limited exposure to foot care education, and moderate self-efficacy levels observed in these populations align with previous findings in other developing countries. Strengthening foot care education as a central component of diabetes management could enhance self-efficacy and reduce the incidence of preventable lower-limb amputations in both settings.