Title: Survey of Foot Complications among Patients Attending Diabetic Foot Clinic in A Tertiary Care Center
Authors: Ajay Gupta, Chethan C, Vijender Anand
DOI: https://dx.doi.org/10.18535/jmscr/v6i8.127
Abstract
Introduction: The prevalence of diabetes is increasing worldwide resulting in foot complications, which leads to poor quality of life and increased cost of living.
Aim: The aim of this study was to understand the spectrum of various foot complications in patients presenting to diabetic foot clinic.
Methodology: A cross sectional study was carried out among diabetic patients visiting foot clinic of a tertiary care centre.
Result: A total of 107 patients (63 - males & 44 - females), type 1(31) and type 2 (76) with diabetic foot complications were analyzed. The commonest foot complications among the study population are diabetic foot ulcers (DFU) in 67, Diabetic peripheral neuropathy (DPN) in 73, Amputations in 42, peripheral arterial disease (PAD) in 37. Other complications noted were osteomyelitis in 12; foot deformities - Charcot foot in 5, Hallux valgus in 26 and Hammer toe in 13.
Conclusion: Foot complications in diabetic patients are very common as observed in our study which leads to significant morbidity and disability.
Keywords: Diabetes, foot, Ulcers, Amputation, Complications.
References
- Diabetes Atlas. International Diabetes Federation, Brussels. 2015. https://www.idf.org/e-library/epidemiology-research/diabetes-atlas.html.
- Bengalorkar GM, Kumar TN. Diabetic foot infections: A review. Int J Biol Med Res 2011;2:453-60
- Al-Rubeaan, K, Al Derwish, M, Ouizi, S, Youssef A.M, Subhani S.N, Ibrahim H.M, Alamri, B.N. Diabetic foot complications and their risk factors from a large retrospective cohort study. PLoS one 2015; 10 (5), e0124446.
- Katsilambros N, Tentolouris N, Tsapogas P, Dounis E. Atlas of Diabetic Foot. Chichester, UK: Wiley-Blackwell; 2003.
- Forlee M. What is the diabetic foot? The rising prevalence of diabetes worldwide will mean an increasing prevalence of complications such as those of the extremities. Continuing Medical Education. 2010;28:152–156.
- Lavery LA, Armstrong DG, Vela SA, Quebedeaux TL, Fleischli JG Practical criteria for screening patients at high risk for diabetic foot ulceration. Arch Intern Med. 1998 Jan 26; 158(2):157-62.
- Yesil S, Akinci B, Yener S, Bayraktar F, Karabay O, Havitcioglu H, Yapar N, Atabey A, Kucukyavas Y, Comlekci A, Eraslan S Hormones. Predictors of amputation in diabetics with foot ulcer: single center experience in a large Turkish cohort. 2009 Oct-Dec; 8(4):286-95.
- Tesfaye S, Vileikyte L, Rayman G: Painful diabetic peripheral neuropathy: consensus recommendations on diagnosis, assessment and management. Diabetes Metab Res Rev. 2011;27(7):629–38.
- Tesfaye S, Boulton AJ, Dyck PJ: Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care. 2010;33(10):2285–93.
- Callaghan BC, Cheng HT, Stables CL: Diabetic neuropathy: clinical manifestations and current treatments. Lancet Neurol. 2012;11(6):521–34.
- Elhadd TA, Robb R, Jung RT, Stonebridge PA, Belch JJF. Pilot study of prevalence of asymptomatic peripheral arterial occlusive disease in patients with diabetes attending a hospital clinic. Practical Diabetes Int. 1999;16:163–166.
- Marso SP, Hiatt WR. Peripheral arterial disease in patients with diabetes. J Am Coll Cardiol. 2006;47:921–929.
- Hirsch AT, Criqui MH, Treat-Jacobson D, Regensteiner JG, Creager MA, Olin JW, Krook SH, Hunninghake DB, Comerota AJ, Walsh ME, et al. Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA. 2001;286:1317–1324.
- Jain AKC, Vishwanath S. Studying major amputations in a developing country using Amit Jain’s typing and scoring system for diabetic foot complications - time for standardization of diabetic foot practice. Int Surg J. 2015;2:26–30.
- Gupta S. Management of diabetic foot. Medicine Update. 2012;22:287-93.
- Jyothylekshmy V, Menon AS, Abraham S. Epidemiology of diabetic foot complications in a podiatry clinic of a tertiary hospital in South India. Indian j health sci 2015;8:48-51.
- Levin ME. Management of the diabetic foot: preventing amputation. South Med J. 2002;95(1):10–20.
- Mayfield JA, Reiber GE, Maynard C. Trends in lower limb amputation in the Veterans Health Administration, 1989–1998. J Rehabil ResDev.2000;37(1):23–30.
- Pecoraro RE, Reiber GE, Burgess EM. Pathways to diabetic limb amputation: basis for prevention. DiabetesCare. 1990;13(5):513–521.
- Reiber GE. Diabetic foot care. Financial implications and practice guidelines. Diabetes Care. 1992;15(1):29–31.
- Reiber GE. Epidemiology of foot ulcers and amputation in the diabetic foot. In: Bowker JH, Pfeifer MA, eds. Levin and O’Neal’s the Diabetic Foot. St. Louis, MO: CV Mosby:13–32.
- Moss SE, Klein R, Klein BE. The prevalence and incidence of lower extremity amputation in a diabetic population. Arch Intern Med. 1992;152:610–616.
- Brownlee M, Cerami A, Vlassara H. Advanced glycosylation end products in tissue and the biochemical basis of diabetic complications. N Engl J Med. 1988;318(20):1315–1321.
- Campbell RR, Hawkins SJ, Maddison PJ. Limited joint mobility in diabetes mellitus. Ann Rheum Dis. 1985;44(2):93–97.
- Sanders LJ, Frykberg RG. Charcot neuroarthropathy of the foot. In: Bowker JH, Pfeifer MA, eds. Levin and O’Neal’s the Diabetic Foot. 6th ed. St. Louis, MO: Mosby; 2001:xxv, 790 p
- Armstrong DG, Lavery LA. Elevated peak plantar pressures in patients who have Charcot arthropathy. J Bone Joint Surg Am. 1998;80(3):365–369.
- Lavery LA, Peters EJ, Armstrong DG, Wendel CS, Murdoch DP, Lipsky BA. Risk factors for developing osteomyelitis in patients with diabetic foot wounds. Diabetes Res Clin Pract 2009;83:347-52.
- Lipsky BA, Berendt AR, Deery HG, Embil JM, Joseph WS. Diagnosis and treatment of diabetic foot infections. Plast Reconstr Surg. 2006;117:212S–238S.