Can We Link Foot Ulcer with Risk Factors in Diabetics? A Study in a Tertiary Care Hospital

Overview

Journal Pak J Med Sci

Specialty General Medicine

Date 2018 Dec 19

PMID 30559788

Citations 14

Authors

Muhammad Imran Hassan Khan

Usama Azhar

Fizza Zubair

Zohaib Abbas Khan

Affiliations

Soon will be listed here.

Abstract

Objective: Although many studies worldwide explained the risk factors for developing Diabetic Foot Ulceration (DFU), little has been done to assess medical factors in DFU formation and link them in patients of Pakistan. This study aimed to link the DFU with different risk factors.

Methods: This descriptive cross-sectional retrospective study was conducted in Diabetes Endocrine and Metabolic Centre / Post Graduate Medical Institute / Lahore General Hospital. Data of all patients presenting between July 2017 to June 2018 were analyzed for risk factors. Analysis was done on SPSS version 21.

Results: Total of 3301 patient were seen during this period, out of which 2052 patient data was picked up as it was complete in respect to the information needed. Middle age, Male gender, Type 2 diabetes, and Hypertension, were insignificantly co-related. High waist circumference, Comorbidity like Neuropathy, Dyslipidemia, Greater body mass index, Poor compliance with Medication and type of medication used (combination of oral and injectable) were found statistically significant predictor for DFU. However retinopathy was not found to be a risk factor of DFU. This result was statistically significant.

Conclusion: Factors like obesity, waist circumference, combination of oral along with injectable therapies, neuropathy, dyslipidemia, retinopathy and poor compliance with medication were statistically significant and can be strongly linked with diabetic foot ulcer. Middle age, Male gender, Type 2 diabetes, and Hypertension were insignificantly co-related. However, further studies are needed in larger population to support these findings.

Citing Articles

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References

Yazdanpanah L, Shahbazian H, Nazari I, Arti H, Ahmadi F, Mohammadianinejad S . Incidence and Risk Factors of Diabetic Foot Ulcer: A Population-Based Diabetic Foot Cohort (ADFC Study)-Two-Year Follow-Up Study. Int J Endocrinol. 2018; 2018:7631659. PMC: 5875034. DOI: 10.1155/2018/7631659. View

Mohammed S, Mikhael E, Ahmed F, Al-Tukmagi H, Jasim A . Risk factors for occurrence and recurrence of diabetic foot ulcers among Iraqi diabetic patients. Diabet Foot Ankle. 2016; 7:29605. PMC: 4794731. DOI: 10.3402/dfa.v7.29605. View

Kiley D, Lam C, Pollak R . A study of treatment compliance following kidney transplantation. Transplantation. 1993; 55(1):51-6. DOI: 10.1097/00007890-199301000-00010. View

Mariam T, Alemayehu A, Tesfaye E, Mequannt W, Temesgen K, Yetwale F . Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients Who Attend the Diabetic Follow-Up Clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-Based Cross-Sectional Study. J Diabetes Res. 2017; 2017:2879249. PMC: 5534295. DOI: 10.1155/2017/2879249. View

Fonseca V . Defining and characterizing the progression of type 2 diabetes. Diabetes Care. 2009; 32 Suppl 2:S151-6. PMC: 2811457. DOI: 10.2337/dc09-S301. View

Boulton A, Vileikyte L, Ragnarson-Tennvall G, Apelqvist J . The global burden of diabetic foot disease. Lancet. 2005; 366(9498):1719-24. DOI: 10.1016/S0140-6736(05)67698-2. View

Monteiro-Soares M, Boyko E, Ribeiro J, Ribeiro I, Dinis-Ribeiro M . Predictive factors for diabetic foot ulceration: a systematic review. Diabetes Metab Res Rev. 2012; 28(7):574-600. DOI: 10.1002/dmrr.2319. View

Parchman M, Pugh J, Romero R, Bowers K . Competing demands or clinical inertia: the case of elevated glycosylated hemoglobin. Ann Fam Med. 2007; 5(3):196-201. PMC: 1886492. DOI: 10.1370/afm.679. View

Nieto-Gil P, Ortega-Avila A, Pardo-Rios M, Cobo-Najar M, Blasco-Garcia C, Gijon-Nogueron G . Hospitalisation Cost of Patients with Diabetic Foot Ulcers in Valencia (Spain) in the Period 2009⁻2013: A Retrospective Descriptive Analysis. Int J Environ Res Public Health. 2018; 15(9). PMC: 6163481. DOI: 10.3390/ijerph15091831. View

10.

Madanchi N, Tabatabaei-Malazy O, Pajouhi M, Heshmat R, Larijani B, Mohajeri-Tehrani M . Who are diabetic foot patients? A descriptive study on 873 patients. J Diabetes Metab Disord. 2013; 12:36. PMC: 3708818. DOI: 10.1186/2251-6581-12-36. View

11.

Hernandez R, Ruggiero L, Prohaska T, Chavez N, Boughton S, Peacock N . A Cross-sectional Study of Depressive Symptoms and Diabetes Self-care in African Americans and Hispanics/Latinos With Diabetes: The Role of Self-efficacy. Diabetes Educ. 2016; 42(4):452-61. PMC: 5034711. DOI: 10.1177/0145721716654008. View

12.

Alahdab F, Wang A, Elraiyah T, Malgor R, Rizvi A, Lane M . A systematic review for the screening for peripheral arterial disease in asymptomatic patients. J Vasc Surg. 2015; 61(3 Suppl):42S-53S. DOI: 10.1016/j.jvs.2014.12.008. View

13.

Younis B, Shahid A, Arshad R, Khurshid S, Ahmad M, Yousaf H . Frequency of foot ulcers in people with type 2 diabetes, presenting to specialist diabetes clinic at a Tertiary Care Hospital, Lahore, Pakistan. BMC Endocr Disord. 2018; 18(1):53. PMC: 6090692. DOI: 10.1186/s12902-018-0282-y. View

14.

Singh N, Armstrong D, Lipsky B . Preventing foot ulcers in patients with diabetes. JAMA. 2005; 293(2):217-28. DOI: 10.1001/jama.293.2.217. View

15.

Khan A, Junaid N . Prevalence of diabetic foot syndrome amongst population with type 2 diabetes in Pakistan in primary care settings. J Pak Med Assoc. 2017; 67(12):1818-1824. View

16.

Dutra L, Novaes M, Melo M, Veloso D, Faustino D, Sousa L . Assessment of ulceration risk in diabetic individuals. Rev Bras Enferm. 2018; 71 Suppl 2:733-739. DOI: 10.1590/0034-7167-2017-0337. View