A STUDY OF RISK FACTORS IN DIABETIC FOOT ULCER IN A TERTIARY CARE HOSPITAL AND STRATEGY OF PREVENTION.

Abstract

Objective: To identify common risk factors in diabetic patients who presented with foot ulceration and present a programme for their prevention.

Methodology: This is a hospital based descriptive study. This study was conducted in the department of surgery Unit – I from Jan, 2015 to July, 2017 at Akhtar Saeed Trust Hospital Lahore 150 consecutive patients with a diabetic foot ulcer (DFU) were included in the study. Various risk factors such as age; gender; peripheral arterial disease; peripheral neuropathy; duration, control and type of diabetes; smoking and education about foot care were noted. During their stay at hospital glycemic control was achieved and diabetic ulcer was treated.

Results: The majority of the patients were males with male to female ratio 3:1.The maximum number of patients were in the 6th decade (40%) followed by 5th decade (31%). All the patients except one were suffering from type 2 diabetes. Diabetic control was poor in 98% patients at the time of admission. 50% of the patients were suffering from diabetes for more than 10 years. 52% patients were smokers. Peripheral neuropathy was noted in 82% patients, whereas peripheral pulses were palpable in 82% patients. 56% patients presented in Wagener’S grade 3 and 4Diabetic ulcer. 15% patients ended up with amputation. 80% of the patients were not educated about foot care by the treating physician. 45 % patients were not aware of foot care. Screening and education of high risk patients are recommended.

Conclusion: Males, smoking, peripheral neuropathy, long duration, poor control, type 2 diabetes and lack of knowledge about foot care are the main reasons for diabetic foot ulcer. Screening of high risk patients is recommended.