scholarly journals Risk Factors, Clinical Features, and Radiographic Abnormalities of Feet in Diabetic Patients

2021 ◽  
Vol 10 (41) ◽  
pp. 3582-3586
Author(s):  
Jayachandra Jayachandra ◽  
Harsha Vishwanath Patel ◽  
Rajendra Prasad Honnaiah

BACKGROUND Foot problems are a leading cause of hospitalization for patients having diabetes mellitus all over the world. Foot ulcers in diabetes precede 85 % of nontraumatic lower-extremity amputations. Fifteen percent develop foot ulcers during their lifetime. Individuals who develop foot ulcers have a decreased health-related quality of life and consume a lot of healthcare resources. Foot abnormalities is a frequently missed diagnosis and a focus in this area of medical education has never been optimal despite its frequency of presentation. In this study, we wanted to determine clinical and radiographic foot abnormalities in diabetic patients. METHODS A cross-sectional study was carried out on 180 type 2 diabetic patients diagnosed as per ADA definition of diabetes, they were categorized into three groups, the first consisted of 60 diabetic patients without neuropathy or foot ulcers, the second had 60 diabetic patients with neuropathy and the third had 60 diabetic patients with both neuropathy and foot ulcer. Based on the clinical examination of the foot and foot X-ray oblique and lateral view of the affected feet along with other relevant investigations were obtained and analysed using descriptive and inferential statistical analysis. RESULTS We observed that poor glycaemic control and duration of diabetes were important risk factors for foot complications in diabetic patients which were statistically significant. Among patients with only diabetes, 3.3 % had HbA1c less than 6, 35 % had HbA1c between 6 - 9 and 61.7 % with HbA1c of more than 9. Among the patients with diabetes and neuropathy, 1.7 % of people had Hba1c of less than 6, 20 % with Hba1c between 6 - 9 and 78.3 % with Hba1c of more than 9. In patients who had diabetes and neuropathy with foot ulcers, 6.7 % had HbA1c of less than 6, among the same cohort 8.3 % had HbA1c between 6 - 9 and 85 % had HbA1c above 9. The prevalence of various radiological abnormalities of the foot was more common in diabetic patients with both neuropathy and foot ulceration (group lll) (83.3 %). The most common abnormality as observed from our study was Osteopenia with osteoporotic changes seen in 36.7 % of Group III patients VS 16.7 % of Group II (patients with diabetes and neuropathy ) and only in 10 % of Group I patients (patients with diabetes without any complications). Vascular calcifications were observed in 26.7 % VS 16.7 % VS 6.7 % in Group III, Group II, Group I respectively. Periosteal reactions were also more common in Group III patients (6.7 %). Subluxation of 2nd, 3rd, 4th, and 5th metatarsals was observed only in 3.3 % of Group III patients. CONCLUSIONS Diabetic foot is one of the most devastating complications of diabetes. Preventing the diabetic foot should be the first priority. This can be achieved by identifying the high-risk individuals with the above said risk factors by proper clinical examination and use of foot X-ray. KEY WORDS Diabetic Foot, Foot Problems, Foot Infections.

2017 ◽  
Vol 4 (8) ◽  
pp. 2777
Author(s):  
Roshan Dath ◽  
U. Venkatkrishna Rao ◽  
Kishore Kumar ◽  
Harish Kumar ◽  
Suresh Kumar

Background: It is a well-known fact that around 15% of patients with diabetes are likely to be affected by foot ulcers during their lifetime. The aim of this study was to evaluate and analyze Amit Jain’s offloading system used in diabetic foot wounds.Methods: A cross-sectional, retrospective study was done at 3 centres namely Brindhavvan Areion Hospital, Synergy Centre for Diabetes and South City hospital in Bangalore, India. The study period was for 1 year from April 2016 to March 2017.Results: 23 cases were included in the study. 16 patients (69.57%) had right foot involved whereas 7 patients (30.43%) had left foot involved. Majority of the patients had foot problems located at forefoot (86.96%). The most common condition where Amit Jain’s offloading was used was in trophic ulcer (61%). In 22 patients (95.65%), the microcellular rubber and ethyl vinyl acetate combination was used whereas in one patient (4.35%), 7 mm of single layered EVA was used. 9 patients (39.13%) had their wounds healed within 8 weeks whereas 11 patients (47.83%) had their wounds healed within 8-16 weeks.Conclusions: Amit Jain’s offloading device is a new offloading device that can be effectively used as an alternative to felted foam. It is based on deflective technique just like felted foam. In this series, 86.98% of the wounds had healed by 16 weeks with this new offloading device. The Amit Jain’s offloading device, which has a scientific rationale based on the deflective offloading as well as usage of visco-elastic material that is accepted worldwide, produces effective wound healing without any complication and without inhibiting patient’s mobility. Amit Jain’s offloading is a level one recommendation for diabetic foot wounds.


2021 ◽  
Vol 7 ◽  
Author(s):  
Zeinab Schäfer ◽  
Andreas Mathisen ◽  
Katrine Svendsen ◽  
Susanne Engberg ◽  
Trine Rolighed Thomsen ◽  
...  

Diabetes mellitus is associated with serious complications, with foot ulcers and amputation of limbs among the most debilitating consequences of late diagnosis and treatment of foot ulcers. Thus, prediction and on-time treatment of diabetic foot ulcers (DFU) are of great importance for improving and maintaining patients' quality of life and avoiding the consequent socio-economical burden of amputation. In this study, we use Danish national registry data to understand the risk factors of developing diabetic foot ulcers and amputation among patients with diabetes. We analyze the data of 246,705 patients with diabetes to assess some of the main risk factors for developing DFU/amputation. We study the socioeconomic information and past medical history of the patients. Factors, such as low family disposable income, cardiovascular disorders, peripheral artery, neuropathy, and chronic renal complications are among the important risk factors. Mental disorders and depression, albeit not as pronounced, still pose higher risks in comparison to the group of people without these complications. We further use machine learning techniques to assess the practical usefulness of such risk factors for predicting foot ulcers and amputation. Finally, we outline the limitations of working with registry data sources and explain potentials for combining additional public and private data sources in future applications of artificial intelligence (AI) to improve the prediction of diabetic foot ulcers and amputation.


2018 ◽  
Vol 5 (2) ◽  
pp. 675 ◽  
Author(s):  
Manikandan Kathirvel ◽  
Viswakumar Prabakaran ◽  
Jayalakshmi Jayarajan ◽  
Ajay Sivakumar ◽  
Vimalkumar Govindan

Background: To analyse the risk-factors contributing to infection with multidrug-resistant organisms.Methods: 150 diabetic patients with foot ulcer were prospectively studied. Detailed clinical history and clinical examination of the ulcer were done for all patients. The microbiological profile was analyzed for each patient. Using internationally accepted criteria, the multidrug-resistant organisms were identified. Risk factors for acquiring MDRO infection were identified using appropriate statistical tools.Results: MDRO were isolated from 99 patients of 150 (66%). 54.8% (153 out of 279) of isolated organisms were multidrug-resistant organisms. By univariate analysis poor glycaemic control, previous hospitalisation, previous history of amputation, previous antibiotic usage, size of the ulcer, necrotic ulcer, recurrent ulcers, higher grade of ulcer, the presence of osteomyelitis, the presence of retinopathy, peripheral vascular disease, neuropathy and polymicrobial culture, were significantly associated with MDRO infected foot ulcers. Analysis by logistic regression indicated that only two factors significantly increased the risk of acquiring MDRO infection. They are recurrent ulcer (OR = 3.39, p <0.05, 95% CI = 1.081-10.664) and higher grade of ulcer (OR = 13.44, p <0.001, 95 % CI =3.595-50.278).Conclusions: The prevalence of MDRO is alarmingly high in infected diabetic foot ulcers. Recurrent ulcers and higher grade of ulcers are more prone to acquire MDROs.


Author(s):  
مريم باراس ◽  
Eidha A. Bin Hameed

Background: Diabetes is on the rise worldwide and is already considered as an epidemic by some experts. So, there is a need to raise awareness on the important factors that can help prevent bacterial infection in wounds of patients with diabetes. Objective: To study the risk factors of developing diabetic foot ulcer (DFU) in patients with diabetes. The study is the first in Yemen to investigate the prevalence of bacterial infection in wounds of diabetic patients. Materials and Methods: This is a case-control study carried out from November 2018 to May 2019. Twenty diabetic patients with foot ulcer and twenty without foot ulcer were examined. Risk factors and clinical profile of patients were studied by using a standardized questionnaire that included gender, age groups, past history of diabetes, duration of the disease, type of diabetes, DFU, type of ulcer, smoking, glucose level, and control of blood glucose level. Results: The risk factors that affected significantly the occurrence of DFU were gender (0.038), age groups (0.010), and duration of diabetes mellitus (DM) while hyperglycemic control, smoking, and family history were not. There was no significant difference (0.977) in mean fasting blood glucose (MBG) between the DM and DFU patients. Conclusions: Male diabetic patients aged more than 55 years and suffering from DM for more than 10 years were most likely to have DFU. Key words: diabetic foot ulcer, diabetes mellitus, risk factors, Yemen 


Author(s):  
V. Savchuk

The aim of the present research was to study the survival of hemodialysis (HD) patients depending on of anemia and character of kidney damage, «hemoglobin variability” Materials and methods: We have conducted a retrospective study of 183 hemodialysis patients who were treated from 2009. to 2012. The starting point of observation was defined the first hemodialysis session. The patients were divided in accordance of hemoglobin (Hb) levels for 4 groups: the level of Hb <70 g/l (n=32) – group I, Hb 70–89 g/l (n=68) - group II, Hb 90-110 g/l (n=65) – group III, Hb≥110g/l (n=28) - IV group. Results. The cumulative survival of patients was 55% at the moment of the end of the study. The cumulative proportion surviving of patients with diabetes mellitus was significantly lower compared to non-diabetic patients – 18% and 57%, respectively. The survival of patients I & II groups was significantly lower than the patients of  groups III & IV: 83.64% and 63.75% versus 31.7% and 29.28%, respectively (criteria Geha-Wilcoxon, Cox-Mantel test, Wilcoxon-Peto, F-criterion Cox log-rank test). The survival of patients with "stable hemoglobin" was significantly higher than in patients with "low of hemoglobin variability " and "high of hemoglobin variability"(р<0,005). Conclusions. Hb level and its variability had a significant effect on the survival of patients who are treated with hemodialysis. The survival of hemodialysis patients with diabetes mellitus was significantly lower than in non-diabetic kidney failure.


Ulcers ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Akaninyene Asuquo Otu ◽  
Victor Aniedi Umoh ◽  
Okon Ekwere Essien ◽  
Ofem Egbe Enang ◽  
Henry Ohem Okpa ◽  
...  

Diabetic foot disease is a major medical, social, and economic problem. This retrospective study assessed the profile of diabetes mellitus patients with foot ulcers in the University of Calabar Teaching Hospital (UCTH), Nigeria. Admission records of all patients admitted unto the medical wards of UCTH over a 5 year period were analysed. The records of diabetic patients were retrieved. Data on patient characteristics and possible risk factors for diabetes mellitus foot ulcers was extracted. Of the 3,882 patients admitted, 297 (7%) were on account of complications of diabetes mellitus. Foot ulcers accounted for 63 (21.2%) of all diabetic admissions. The elderly constituted the majority of patients admitted with foot ulcers. The average duration of stay of diabetics with foot ulcers was 38.5 days. Diabetics admitted for other conditions had average duration of admission of 15.8 days. Staphylococcus aureus was the commonest organism isolated from swabs of foot ulcers. Most of the organisms identified from ulcer swab cultures were sensitive to quinolones and resistant to penicillins. These diabetic foot ulcers were significantly associated with peripheral sensory neuropathy, peripheral vascular disease, intermittent claudication, and walking barefoot. An effective diabetes foot programme is required to address these risk factors and reverse the current trend.


2019 ◽  
Vol 16 (6) ◽  
pp. 1373-1382 ◽  
Author(s):  
Ze‐Hao Huang ◽  
Si‐Qing Li ◽  
Yan Kou ◽  
Lei Huang ◽  
Ting Yu ◽  
...  

2016 ◽  
Vol 12 (4) ◽  
Author(s):  
Damian Dzienniak ◽  
Jacek Cieślik

AbstractDiabetic foot is one of the most severe complications of diabetes. Early diagnosis of this syndrome can ensure proper medical care and adequate treatment. Various image analysis methods can be used to speed up the diagnosis process, and automated diagnosis can be applied as a screening technique to reduce its cost. Introducing auxiliary diagnostic parameters may help to detect polyneuropathy or neuropathy, both of which often precede the appearance of diabetic foot syndrome. The present paper describes a study performed on a group of diabetic patients by analyzing plantar pressure distribution images. As part of this study, 2D discrete cosine transform (DCT) is computed for the forefoot and rearfoot regions of each diabetic subject in a group of 37 patients. Three new DCT-based parameters are introduced to help to detect polyneuropathy or at least indicate that the patient may have polyneuropathy without a time-consuming examination. The results indicate a certain relationship between these parameters and the presence of polyneuropathy. This information could be used in further diagnosis to prevent foot ulcers from developing in patients with diabetes.


2016 ◽  
Vol 7 (1) ◽  
pp. 29605 ◽  
Author(s):  
Samer I. Mohammed ◽  
Ehab M. Mikhael ◽  
Fadia T. Ahmed ◽  
Haydar F. Al-Tukmagi ◽  
Ali L. Jasim

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