High Risk Foot Among Type-2 Diabetes Mellitus Patients in a Tertiary Care Hospital
Annals of International medical and Dental Research
Feet of diabetic persons are at a high risk of developing complications and their prevalence is very high. Uncontrolled diabetes i.e. hyperglycemia particularly chronic hyperglycemia plays the most critical role in developing all forms of macro and microvascular complications in foot. The "high risk foot" can be identified by simple clinical examination. A structured screening program for "High Risk Foot" integrated with all diabetic care units is essential. Objectives: The study was initiated
... o determine the frequency of "high-risk foot" among Type 2 diabetic patients. Methods: It was a crosssectional observational study, conducted among 324 Type 2 diabetic patients attending BIRDEM General Hospital, Dhaka, Bangladesh. All participants were interviewed by an administered questionnaire, underwent clinical examination and review of medical records from the diabetic guide book of the patients and hospital records. Results: Among a total of 324 patients, 198(61%) patients were having high-risk feet. Of the diabetics with high risk foot-loss of protective sensation 73.2%; absent pedal pulse 23.2%; history foot ulcer 25.3%; limited joint mobility 15.2%; foot deformity 11.1% and previous foot amputation 3.5%. The study population had poor glycemic status (HbA1c 10.81+5.23%). Other variables age 55.43 (± 11.062) years; BMI: 25.33+5.7 kg/m²; duration of diabetes 14.24+7.25 years; sex ratio (M: F) 1.3:1; family history of DM 71.9%; hypertensive 53.1%; smoker 73.5%; dislipidemia 52.8%, albuminuria 58.6%, and retinopathy 53.7%. Males are significantly higher in the high-risk foot. Conclusion: This study documented a very high frequency of high risks foot in our diabetic population. Peripheral Neuropathy (PN) and PVD are two common forms of high risk foot and these are influenced by a longer duration of diabetes, the presence of albuminuria for PN, and retinopathy. Male sex, longer duration of diabetes, presence of hypertension and smoking for PVD. Regular foot examination and treatment to target patients will modify the modifiable risk factors and thereby prevent foot ulcers and amputation.