Detection of high risk foot in diabetic patients attending diabetic clinic

Dr. Amit Kumar Gupta; Dr T Rajdev Patro; Dr Saurabh Srivastava; Dr Amitesh Agarwal; Dr Gunjan Kishor Sharma; Dr Ajai Kohli

Volume : VII, Issue : III, March - 2018

Detection of high risk foot in diabetic patients attending diabetic clinic

Dr. Amit Kumar Gupta, Dr T Rajdev Patro, Dr Saurabh Srivastava, Dr Amitesh Agarwal, Dr Gunjan Kishor Sharma, Dr Ajai Kohli

Abstract :

Background: Diabetes and the diabetic foot ulcer (DFU) have made their mark in society, with the prevalence of diabetes being four times higher than all cancers combined. Infected DFU is a major cause of prolonged hospital admission and contributes over 90% of non traumatic lower limb amputations (LLAs), which is more than a million amputations/year. As a result, subjects with DFU maintain poorer quality of life, with higher baseline depression rate, and 5–year mortality rates of up to 74% .Objectives: The study mainly aimed at making foot care and clinical examination of foot an integral part of diabetes care in patients attending diabetic clinic and also to identify High risk foot in diabetic patients attending diabetic clinic. Material and Methods: Present study was a cross sectional hospital based study which was done at Promhex Amrapali Hospital, Greater Noida from January 2017 – June 2017 (6months). A total of 180 patients with diabetes attending the clinic were enrolled in the study. A clinical assessment of vascular and neuropathic compromise was done by a Semmes–Weinstein 10 g monofilament, VPT– Biothesiometer for Viation senses and Ankle Brachial Index (ABI) by using hand held doppler. Results: This study shows that significant number of diabetic patients (15.8%) coming to Promhex Amrapali Hospital, diabetic follow up clinic have (Diabetic Foot Ulcer) DFUs. Diabetic foot ulcer was observed among 32 (17.7%) diabetic patients. The mean age of the study population was 50.72�13.39 years. 47.2% of the patients had presence of peripheral vascular disease which is almost half of the study population. The amputation rates were higher in neuro–ischaemic group (46%). Conclusion: The prevalence of diabetic foot ulcer among diabetic patients in Promhex hospital was 15.8%. From our study we also confirm that peripheral neuropathy is the predominant factor for foot ulceration as the insensate foot is prone for undue trauma. The coexistence of peripheral vascular disease worsens the morbidity and mortality of the diabetic foot syndrome.