Dietary misconceptions in Pakistani diabetic patients

To find out prevalence of various myths regarding diet of diabetics in local population. This was a cross sectional study conducted at diabetic clinic and medical OPD in Civil Hospital Karachi from January 2008 to December 2008. A total of 409 diabetic patients of either gender, age 18 or above who had given the consent were randomly selected. A pretested semi structured questionnaire regarding sociodemographic profile and various dietary myths regarding diabetes were used to get information from the study group. Out of 409 diabetic subjects 207 [50.6%] were male. Average age was 51.6 +/- 10.4 years. Most of the participant 397 [97.1%] were type 2 diabetics. Large number of subjects 83 [20.3%] were either illiterate or had had primary schooling 112 [27.4%]. Most of the participants 256 [62.6%] never received any diabetic education. Majority of study subjects 348 [85%] believed in special diet for control of blood sugar level while large proportion of study population 335 [81.9%] did not use underground vegetables and same number of participants had strong belief in bitter vegetables as natural remedy. Forty one percent study subjects had myths regarding fruits while 301[73.5%] said that rice is prohibited. Study population who believed in special diet showed significant p-value [<0.005] when compared with those who did not. Similarly the group that had received diabetic education showed significant p-value when compared with those who did not. A large number of diabetic patients especially those who never received any diabetic education have strong dietary misconceptions

Clinical profile and management outcome of diabetic foot ulcers in a tertiary care hospital

To determine major risk factors and management outcome of diabetic foot ulcers in order to prevent amputation. Cross-sectional descriptive study. Study was conducted at the Department of Medicine, Civil Hospital Karachi, from January 2005 to December 2006. One-hundred and sixteen consecutive diabetic patients, with foot ulcers of Wagner's grade 1 to 4 were assessed at baseline for demographic information, detailed history, neuropathy, peripheral pulses and frequency of diabetic complication. Glycemic control was determined on the basis of HbA1c levels. Appropriate medical and surgical treatments were carried out and patients were followed-up until healing or for 6 months as end point of study. Outcome was recorded as healed, incomplete healing and amputated. A majority of subjects had type 2 diabetes [95.7%] with male predominance [66%]. The mean age was 54.29 +/- 7.71 years. Most of the patients were overweight, hyperglycemic and had diabetes > 10 years duration. Neuropathic ulcers were found in 91 [78.4%] patients, while rest of the 25 [22.6%] had neuroischemic ulcers. Wound cultures revealed polymicrobial organisms. Foot ulcers of 89 [77.7%] patients healed without amputation and 17 [14.7%] patients had minor or major amputations. Long-duration of diabetes, poor glycemic control and type of foot ulcers had effect on prognosis [p<0.05]. Effective glycemic control, optimal wound care, aggressive medical management and timely surgical intervention may decrease disabling morbidity with better outcome of diabetic foot ulcer