Foot abnormalities in diabetics: prevalence and predictors in Basrah

ABSTRACT

Diabetic foot abnormalities are clearly one of the most important complications of diabetes mellitus [DM] and the leading cause of hospitalization with substantial morbidity, impairment of quality of life, and engender high treatment costs. The aim of this study was to estimate the prevalence of diabetic foot abnormalities among patients with type 2 DM and the predictors of these abnormalities in Basrah. This was a cross sectional study of patients attending the out patient clinic of two hospitals in Basrah [the General and the Teaching] for the period from January to the end of December 2005. All patients had type 2 DM. The total number of patients was 182 [80 males and 102 females]. Diabetic foot abnormalities were reported in 46.7% of patients. Most patients had more than one abnormality. Structural foot abnormalities reported in diabetic patients were prominent metatarsal heads in 36.2%, wasting in 11.5% hammer toes in 10.9%, pes cavus in 5.4%, claw toes in 3.8%, and amputees in 2.1%. While skin changes included dryness of the skin in 17%, fissures in the skin in 14.7%, callosities in 14.2%, Tinea pedis in 13.7%, foot ulcer in 13.7% and nail changes in 7.1%. Peripheral neuropathy and dermopathy were seen in 21.9% and 6% respectively. Variables predicting foot abnormalities were higher age, male sex, less school achievement, longer duration of DM, higher BMI, smoking history, low social class, insulin use, hypertension, heart failure and proteinuria