RESUMEN
Background: 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 揾igh risk foot� can be identified by simple clinical examination. A structured screening program for 揌igh Risk Foot� integrated with all diabetic care units is essential. Objectives: The study was initiated to determine the frequency of 揾igh-risk foot� among Type 2 diabetic patients.Methods:It was a cross-sectional 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/m� 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.
RESUMEN
Introducción: El pie diabético y su impacto sobre los sistemas de salud han sido puestos de manifiesto en diferentes estudios en todos los continentes. Se introduce el concepto de pie de riesgo como una entidad a tener en cuenta en la prevención del pie diabético.Objetivo: determinar la frecuencia y principales características del pie de riesgo, de acuerdo con su estratificación en grados, en el paciente diabético.Métodos: se realizó un estudio clínico transversal y descriptivo con 212 personas con diabetes que acudieron al Centro de Atención al Diabético de La Habana, en el período de enero 2012-2013. El análisis de los resultados incluyó las estadísticas descriptivas de todas las variables, análisis bivariados mediante comparación de medias.Resultados: el pie de riesgo es frecuente entre la población diabética estudiada (56,0 por ciento), así como la neuropatía periférica (63,7 por ciento) y la angiopatía ligera (23,1 por ciento).Conclusiones: el examen físico vascular y neurológico de los miembros inferiores es importante en la identificación y estratificación del riesgo, el cual existe en una elevada prevalencia entre la población diabética. Juegan su rol el tiempo de evolución de la diabetes, la neuropatía periférica de miembros inferiores, la enfermedad vascular periférica ligera, los dedos en martillo y la hiperqueratosis plantar; en cambio, el descontrol glucémico, el índice de masa corporal y el hábito de fumar no influyen, a corto plazo, en la estratificación del pie de riesgo(AU)
Introduction: The diabetic foot and its impact on health systems have been dealt with in various studies conducted in all continents. The concept of high risk foot is presented as an entity to bear in mind in the prevention of the diabetic foot.Objective: determine the frequency and main characteristics of high risk foot in diabetic patients based on its stratification into grades.Methods: a descriptive cross-sectional study was conducted of 212 diabetic patients cared for at Havana Diabetes Care Center from January 2012 to 2013. Analysis of results included descriptive statistics for all variables and bivariate analysis based on comparison of means.Results: the diabetic population studied showed a high prevalence of high risk foot (56.0 percent), peripheral neuropathy (63.7 percent) and mild angiopathy (23.1 percent).Conclusions: physical vascular and neurological examination of lower limbs is important to identify and stratify risk, which is highly prevalent among the diabetic population. In the stratification of high risk foot, a significant role is played by the time of evolution of diabetes and the presence of lower limb peripheral neuropathy, mild peripheral vascular disease, hammer toe and plantar hyperkeratosis. However, lack of glycemic control, body mass index and smoking do not have a short-term effect on such stratification(AU)