A Prospective Study on Prevalence of Foot ulcers in diabetic patients visiting Surgery Department in a Tertiary Care Teaching Hospital
Background: Diabetes Mellitus (DM) is one of the most widespread non communicable diseases across the world. Two types of complications are encountered usually with DM: microvascular and macrovascular. Diabetic neuropathy is one of the most commonly occurring microvascular complications, of which the most common type is distal symmetrical neuropathy or polyneuropathy. Patients who present with diabetic foot ulceration are heterogeneous.
Methods: A checklist was prepared to enter the data already recorded in the case record. This checklist was pilot-tested by recording data from positive case records before analyzing the checklist. A Research Assistant was involved in collection of data from the Medical Records.
Results: In the present study, 26 patients with DM only and 40 patients with DM foot ulcers were included. With regard to gender distribution, among cases and controls, males were more compared to females. Among cases 28.7% and among controls 75% were males. Age distribution showed more than 75% of the cases and controls were in the age group of 30–60 years. In some of the cases and control subjects, the lipid profile values were not available and hence the comparison of lipid profile was done with available data. The mean values of lipid profile was high among cases compared to controls but was not statistically significant except HDL (p < 0.05). The mean HDL value for diabetic patients with foot ulcers was 37.3± 8.25 whereas that for the non-foot ulcer patients is 31.3± 7.85.
Conclusion: Middle-aged male diabetics are most likely to have foot complications. It can be drawn from this study that socio-demographic factors like age, gender along with factors like glycemic control and dyslipidemia are associated with foot ulcers in diabetic patients. It is binding on the health care provider to control these have risk factors to prevent development of complications in diabetic patients with foot ulcers and improve the quality of life.
2. Al-Taw¿q, Jaffar A, John Drow, Jane A. Presentation and Outcome of Diabetic Foot Ulcers in Saudi Arabian Patients. Advances in Skin & Wound Care 2009;22(3):119–121. doi: 10.1097/01.ASW.0000305450.33693.f8.
3. Al-Wahbi AM. The diabetic foot in the Arab world. Saudi Med J 2006; 27:147–53.
4. Wrobel JS, May¿eld JA, Reiber GE. Geographic variation of lower extremity major amputation in individuals with and without diabetes in the Medicare population. Diabetes Care 2001;24:860–4.
5. Al-Wahbi AM. The diabetic foot in the Arab world. In: Gill G, editor. Diabetes in the Arab World. Cambridge: FSG Communications 2005.
6. Dargis V, Pantelejeva O, Jonushaite A, Vileikyte L, Boulton AJ. Bene¿ts of a multidisciplinary approach in the management of recurrent diabetic foot ulceration in Lithuania: A prospective study. Diabetes Care 2009;22:1428–31.
7. Department of Health. Improving diabetes services: The NSF two years on. Department of Health, London. Available from: URL: www.dh.gov.uk/ PublicationsAndStatistics/Publications/Publications Policy And Guidance/
Publications Policy And Guidance Article/fs/ en. 2005. (Accessed 12th
8. Thanh D, Aristidis V. The InÀuence of Gender as a Risk Factor in Diabetic Foot Ulceration. Available from: URL:http://www.woundsresearch.com/ article/8707. (Accessed on 10th July 2011).http://www.woundsresearch.com/article/8707. (Accessed on 10th July 2011).
9. Vincent Lopez Rowe. Diabetic Ulcers. Available from: URL: http://emedicine. medscape.com/article/460282-overview. (Accessed on 10th July 2011).
10. Faridah K, Azmi MT. Retrospective study of predictors for foot ulceration among diabetic patients attending Kuala Langat health centre from 1999 to 2008. Journal of Community Health 2009:15(2): 43–59.
11. Ramani A, Nayak SS, Gopalakrishna K, Kundaje GN. Glycemic control and its relationship to diabetic foot ulcers; Indian J Pathol Microbiol 1991;34(3):161–5.
12. Hamza K, Zahidullah K, Inamullah K, Jamal ud Din, Sadiq U, Bughdad K. Factors contributing to the development of diabetic foot ulcers and role of health literacy. Available from; URL: http://www.scopemed.org/ mnstemps/27/27-1298387017.pdf. (Accessed on July 10th 2011).
13. Katy Dunn. Preventing amputation in patients with diabetes Wounds UK. Clinical Practice Development 2007;3(1):22–30.