Hemostatic variables in Arab diabetics

Blood coagulation studies showed that patients with non-insulin-dependent diabetes mellitus [NIDDM] had significantly higher fibrinogen, FVIII:C, ristocetin co-factor, FV, FIX, lower ATIII, and PCV than those with insulin-dependent diabetes mellitus [IDDM]. Diabetics with IDDM had a significantly higher ATIII, ristocetin co-factor, lower plasminogen and alpha-2-antiplasmin, and more enhanced platelet aggregation responses to ristocetin than age-matched controls. Patients with NIDDM as compared with controls, exhibited higher levels of fibrinogen, ristocetin co-factor, FVIII:C, FIX, and platelet count, but lower plasminogen, alpha-2-antiplasmin and PCV, reduced platelet aggregability to collagen, ADP, and ristocetin. Diabetics with retinopathy and nephropathy had still higher levels of fibrinogen, FVIII:C, ATIII and ristocetin co-factor than those without complications. These results are in accord with many similar studies in Caucasians. It is concluded that the pattern of the changes in hemostatic variables noted in Saudi diabetics do not confirm the existence of racial and/or geographical variations in the hemostatic changes associated with diabetes mellitus

Pattern of diabetic foot lesions in Saudi Arabia: experience from King Khalid University Hospital, Riyadh

A retrospective study was carried out to estimate the magnitude and pattern of foot lesions seen in diabetics living in Saudi Arabia. A review of the records of 1010 diabetic patients seen at King Khalid University Hospital, Riyadh, revealed an overall prevalence of 10.4% for diabetic foot lesions. Of these, 88 patients were further characterized; 55 [62 .5%] were males and 33 [37.5%] were females. Seventy-five patients [85.2%] were Saudis and 13 [14.8%] were non-Saudis. The average age was 58 years. Eighty-five patients had type 2 diabetes and three had type 1. The spectrum of foot lesions included: 10 cases of cellulitis, 33 cases of ulcers, 29 cases of gangrene, and 16 cases of abscess. Evidence of peripheral vascular disease was present in 48 patients [54.5%] while peripheral neuropathy was found in 43 [48.8%]. Surgical debridement with prolonged dressing was done in 58 patients [66%] while amputation was performed in 30 [34.1%]. The average hospitalization was 6.8 weeks. Diabetic foot lesions constitute a major complication of this disease in Saudi Arabia. The high amputation rate is a source of concern and improved techniques are urgently needed to reduce this serious outcome