Determinants of the risk for diabetic foot ulceration in Sohag University Hospital

ABSTRACT

One of the most common complications of diabetes in the lower extremity is the diabetic foot ulceration [DFU]. To identify the determinants of the risk for diabetic foot ulceration [DFU] in terms of peripheral neuropathy [PN] or peripheral vascular disease [PVD] among a sample of diabetic foot patients. A cross sectional study included 100 diabetic foot patients attending Sohag University Hospital for follow up during the period from January 2009 to January 2010. They were subjected to complete medical history taking and thorough clinical examination. Diabetic Neuropathy Symptoms [DNS] along with the Diabetic Neuropathy Examination [DNE] scores were used together to define and assess PN. PVD diagnosis was based on identification of claudication pain symptoms; absent or weak foot pulses on palpation of the dorsalis pedis and/or the tibialis posterior arteries; coldness of skin; and finally confirmed by arterial doppler of lower limbs. The mean age of the patients was 57.92 +/- 9.2 years; 65% were males and 79% lived in rural areas. The majority [79%] had type 2 DM with mean disease-duration of 13.4 +/- 6.9 years. Fifty percent of the study patients were smokers and ex-smokers, 33% were hypertensive and 24% had previous history of foot ulceration or amputation. Male gender, old age, low socioeconomic status, smoking, hypertension, type 2 DM, long duration of DM, uncontrolled DM, and previous history of foot ulceration, amputation or other diabetic complications were all significant determinants of PN and PVD; two major risk factors of DFU