scholarly journals Prevalence of diabetic complications and risk factors among diabetic foot ulcer patients: a retrospective hospital-based study

2018 ◽  
Vol 5 (11) ◽  
pp. 3608
Author(s):  
Shanmuga Raju P. ◽  
Venkata Ramana N. ◽  
Surya Narayana Reddy V. ◽  
Bhagya Seela S. ◽  
Sachin G.

Background: Diabetic foot ulcer is a painful, demands increased health care utilization, and increases healthcare costs for the patients as well as the health care system. The purpose of this study was to analysis the prevalence of diabetic foot complications and risk factors among diabetic patients at tertiary care Hospital, Karimnagar.Methods: Total 60 sample sizes were included in the study. The study was conducted at General Surgery ward, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar from July 2017 to June 2018. Demographic, complications and risk factors were recorded, and outcomes were analyzed using SPSS statistics version 21.0.Results: The Mean age of the study group is 50.31±14.26 years. The male to female distribution is 47 (78.3%) and 13 (21.7%) respectively. The mean duration of illness in days is 96.68±289.21, while mean HbA1C is 9.44±9.02. The mean fasting blood sugar and postprandial blood sugar is 159.78±70.01 and 157.78±86.28 which shown no significance difference (p = 0.87). Odds ratio with 95% confidence interval was computed to the level of significant.Conclusions: There was no significant outcome was found in diabetic foot ulcer. Patient with high risk complications need as early detection, foot care education, moderate physical, exercise, fitted foot wear and diabetic diet should be decrease the risk of diabetic foot ulcers.

2019 ◽  
Vol 34 (1) ◽  
pp. 52-57
Author(s):  
AL Gaddafi ◽  
DK Das ◽  
G Faruque ◽  
Z Islam ◽  
MA Rahman ◽  
...  

A descriptive type of cross sectional study among 210 diabetic patients with foot ulcer was carried out in Diabetic Association Medical College during the period of May 2016 to April 2017 and were categorized based on Meggitt-Wagner system to find out the complications, management, below knee amputation rate and mortality rate. The aim of this study was to practise a profile of diabetic foot ulcer (DFU), complications and its management to assess the outcome of the surgical interventions. Majority of the patients were male 112(53%), and most of them 116 patients (55.23%) presented within Wegner grade - 2 and grade-3 diabetic foot ulcers. The duration of diabetes more than 10 years was 116 (55%). 99 (47%) patients out of 210 patients developed diabetic neuropathy. 76 (36%) patients presented with CKD. Lack of awareness about diabetes mellitus and its lower limb complications, poor compliance to the treatment, poorly controlled blood sugar levels, delay in diagnosis, and late presentation to the tertiary care center, associated habit of smoking are all factors which lead to incidence of DFU at an earlier age than that seen in other studies. After admission of diabetic foot ulcer patients, diabetic foot ulcer is classified according to Wagner grading and treated the diabetic foot ulcer patients as the using protocol ’!1.Assesment whether it was conservative or surgical. 2. Optimal blood sugar control. 3. Systemic antibiotic. 4. Moist wound environment. 5. Offloading such as total contact casting. 6. Improves peripheral arterial circulation due to lack of vascularity. 7. Surgical debridement or minor amputation or major amputation. In case of G-4 or G-5 patients, ischemia was treated before debridement or amputation so that vascular circulation improved in the ulcer area and then healing potential was fastened. Bangladesh Heart Journal 2019; 34(1) : 52-57


Author(s):  
Dr. Sanvar Mal Kantva ◽  
Dr. Mahendra Kumar

Introduction: Diabetes is a metabolic disorder which affects not only carbohydrate but also protein and fat metabolism. Diabetes is also associated with acute as well chronic complications. Almost most of the organs, tissues and systems are affected due to long standing diabetes mellitus. Thus, adult and elderly with long standing diabetes patients often present to the clinics with multiple complications. Among all these well-known complications, diabetic foot ulcer is the most common. It affects as many as 15% of patients with diabetes mellitus during their lifetime Material and Method: The study was a hospital based cross sectional study. Present study was carried out at outpatient department of General Surgery. After their verbal informed consent after explaining them the nature of the study. Patient confidentiality was maintained. The patients diagnosed with diabetic foot ulcer were given appropriate treatment, follow up and health education. The study patients were not subjected for any kind of invasive procedure for the present study purpose. Results: 64.0% patients were having peripheral neuropathy, 73% were having >10 years of diabetes, 49% were having peripheral arterial disease, 34% patients were having diabetic Charcot joint & 26% were having uncontrolled hyperglycemia. Conclusion: Diabetes Mellitus is a lifelong disease and diabetic foot complications can be life threatening, physically incapacitating, costly to treat and result in extensive morbidity. Keywords: Diabetes, foot ulcers, neuropathy


2018 ◽  
Vol 5 (5) ◽  
pp. 1770
Author(s):  
R. Murugan ◽  
S. Padma ◽  
M. Senthilkumaran

Background: Diabetic foot ulcer is the one among and the most common complication of diabetes mellitus patients. Various studies from over the world for the past 2 decades discuss the important risk factors that decide the prevention and outcome of diabetic foot ulcer. In our prospective study we have discussed the risk factors focused on prevention and treatment of diabetic foot ulcer in a rural tertiary medical care centre.Methods: Totally 940 patients with the clinical diagnosis of diabetic foot ulcer admitted in our hospital surgical department were studied prospectively with their clinical symptoms and signs of diabetic foot ulcer and various evaluations done for the comorbid conditions with the help of other specialty departments. All these risk factors studied in our rural based tertiary medical centre were collected in a designed format were studied and discussed in comparison to the chosen data available in various studies done at various countries.Results: All the 940 patients admitted for diabetic foot ulcer who underwent a methodical evaluation for risk factor showed an elevated HbA1c more than 8 in 720 (77.5%) patients, bony involvement like osteomyelitis in 274 patients (29%) , peripheral vascular disease in 421 (44.9%), neuropathy in 533 patients (56.7%), nephropathy 163 (17.34%), retinopathy in 102 (10.85%) and heart disease in 375 (39.89%).Conclusions: Proper protocols to the prevention and management of foot ulcer in diabetic patients have not reached many health care centres and it is imperative to stress on the related comorbid risk factors which influence the prevention and healing of diabetic foot ulcer. Present study done at a rural tertiary health care centre is mainly focused on the incidence of risk factors which modulates and modify the diabetic foot ulcer prevention and management. This study aims to support the health professionals to identify the risk factors apart from the clinical picture of diabetic foot ulcer that may enhance the efficient management and avoid the unnecessary morbidity and mortality. 


Author(s):  
S. Kavipriya ◽  
Khalilur Rahman

Background: The goal of this study was to estimate the disease burden of diabetic foot ulcer (DFU) admissions in a tertiary care hospital in a developing country in terms of clinical profile and outcome. Method: In this descriptive study, the data were collected from the medical record of diabetic patients with foot ulcer who were treated in Saveetha medical college and hospital between the period of February to November 2020. The demographic characteristic, type of foot lesion, etiology, isolated microorganism, treatment, and outcome were reviewed. Results: There were 180 admissions with diabetic foot problems involving 100 patients. All of the patients had type 2 diabetes, and there was no gender bias. The average age was 50, and diabetes control was poor. The majority of patients had no knowledge what had caused their symptoms. In 56 % of cases, ulcers were neuropathic, 25% were neuro ischemic, and a smaller fraction were pure ischemia. More than 70% of ulcers were Wagner grade 3 or higher, with infection occurring in nearly every patient. Gram-negative bacteria were the most prevalent isolates from culture. A total of 30 lower extremity amputations (LEAs) were performed at various levels of the foot. Conclusion: Diabetic foot problems are a source of morbidity, a reason for LEA surgery, and a cause of death in people who have diabetes mellitus.


2018 ◽  
Vol 5 (5) ◽  
pp. 1274 ◽  
Author(s):  
Manohar Shankarrao Chavan

Background: Foot ulceration is preventable, and relatively simple interventions can reduce amputations by up to 80%. The objective of the present research was to study the prevalence and risk factors of diabetic foot ulcer among diabetic patients  Methods: Present study was hospital based cross sectional study carried out at outpatient department of General Medicine for a period of January 2018 to June 2018 among 200 diabetic patients. All eligible patients willing to participate were included in the present study. Diabetic foot ulcer was diagnosed as per the standard criteria and based on the physician acumen. An attempt was made to identify the risk factors like smoking etc. The diagnosed patient was given appropriate treatment.Results: Males were more than females. majority of the patients were found in the age group of 51-60 years (35.5%). Majority of the diabetic patients were from rural area i.e. 84.5%. Majority were illiterate i.e. 69%. 21.5% were found to be smokers. 40% were using alcohol regularly. 36.5% were overweight and 14% were obese. Prevalence of diabetic foot ulcer among diabetic patients was found to be 16%. Age, residence, literacy, duration of diabetes and obesity were not found to be significantly associated with DFU. Diabetic foot ulcer was found to be significantly associated with being male, tobacco chewers, tobacco chewers + smokers, alcoholics, smokers + alcoholics, Family history of diabetes, and insulin users.Conclusions: Prevalence of diabetic foot ulcer among diabetic patients was very high. Tobacco use, alcohol use, mixed of tobacco and alcohol use, and family history of diabetes were significant risk factors for diabetic foot ulcer.


2021 ◽  
Vol 44 (4) ◽  
pp. E11-16
Author(s):  
Muzammil H. Syed ◽  
Mohammed Al-Omran ◽  
Jean Jacob-Brassard ◽  
Joel G. Ray ◽  
Mohamad A. Hussain ◽  
...  

Purpose: To estimate the positive predictive value (PPV) of Canadian ICD-10 diagnostic coding for the identification of hospitalization related to a diabetic foot ulcer (DFU). Methods: Hospitalizations related to a neuropathic and/or ischemic DFU were identified from the Discharge Abstract Database (DAD) records of a single Canadian tertiary care hospital between April 1, 2002 and March 31, 2019. The first coding approach required a most responsible diagnosis (MRDx) code for diabetes-specific foot ulceration or gangrene (DSFUG group). Three alternative coding approaches were also considered: MRDx code for lower-limb osteomyelitis (osteomyelitis group); lower-limb ulceration (LLU group); or lower-limb atherosclerotic gangrene (atherosclerosis group)—each in conjunction with a non-MRDx DSFUG code on the same DAD record. From all eligible DAD records, random samples were drawn for each coding group. DAD records were independently compared by a masked reviewer who manually abstracted data from the entire hospital record (reference standard). The PPV and 95% CI were generated. Results: Out of 1,460 hospitalizations, a total of 300, 50, 33 and seven records were included from the DSFUG, osteomyelitis, LLU and atherosclerosis samples, respectively. Compared to the reference standard, the PPV for all 390 records was 88.5% (95% CI 84.9 to 91.5). The DSFUG group had the highest PPV (90.0%, 95% CI 86.0 to 93.2), followed by the atherosclerosis (85.7%, 95% CI 42.1 to 99.6), LLU (84.9%, 95% CI 68.1 to 94.9) and osteomyelitis (82.0%, 95% CI 68.6 to 91.4) groups. Conclusion: Based on data from a Canadian tertiary care hospital, the specified coding algorithms can be used to identify and study the management and outcomes of people hospitalized with a DFU in Ontario.


Author(s):  
Sheena Marin Thomas ◽  
Ishita Gajjar Nitin ◽  
M. Uday Kiran Reddy ◽  
Harsha Devi S.

Objective: To assess the knowledge with a diabetic foot ulcer, to evaluate the severity and grade of diabetic foot ulcer, to study the self-care behaviour and medication adherence in a patient with diabetic foot ulcer and to counsel the patients.Methods: The KAP, self-care foot behaviour and MMAS-8 questionnaire were given during interview; severity using Wagner’s scale was assessed. Knowledge, attitude, self-care foot practice and adherence was measured based on various parameters such as demographic factors, clinical characteristics, and medication taking characteristics. It was measured before and after the patient counselling to see improvement in the quality of life.Results: In the study period of 6 mo 111 cases were gathered. There were 74 (66%) patients who were illiterate; the patients with low economic status were 63 (56%). Patients who are illiterate have poor knowledge and poor self-care behaviour, in our study 74 (66%) are illiterate which improved after counselling and 59 patients with high knowledge. Medication adherence is also associated with the education of the patient. After counselling and providing knowledge most of the patients are having high KAP scores. Wagner’s scale for the study of the severity shows that most of the patients 30 out of 111 are having Grade 4 of the score which shows the need of counselling and education towards foot care. Improvement in the self-care practice and on safety and prevention was seen after counselling.Conclusion: Knowledge, attitude, self-care practice and adherence of the patient can be improved by establishing a good patient-provider relationship and giving proper patient counselling to the patient or their relatives.


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