A clinical study of risk factors associated with amputation in diabetic foot disease patients attending a tertiary care hospital in a rural setting

Abstract

Background: Diabetes mellitus is a disease of complications, which is rapidly increasing in prevalence worldwide. The total population affected by diabetes is projected to rise from 171 million in 2000 to 366 million by 2030. Approximately 20% of all diabetics who visit the hospital are admitted for foot problems. Diabetic foot ulcers and amputations continue to cause considerable morbidity among persons with diabetes throughout the world. Amputations are considered as a very debilitating complication of diabetes. Vast majority of diabetic foot complications resulting in amputation begin with formation of skin ulcers. Objectives: The main objective of this study is to examine various risk factors to predict lower extremity amputation in diabetic patients and to understand various measures which will reduce the level of amputation. Subjects and Methods: Fifty diabetic patients with foot lesion admitted in our hospital from September 2016 to August 2018 were studied by taking detailed history and thorough clinical examination. Grading of the foot lesions was done by Wagner's staging. Results: The incidence of foot lesion was higher in 51–60 years' age group in males and females. Majority of the patients (38, 76%) had a history of trauma as a predisposing factor to diabetic foot. Out of 20 patients walking barefoot, 12 people (60%) had amputations. Conclusions: It is concluded that rural origin of the patients was found to be another predisposing factor for the development of diabetic foot. This is due to the illiteracy of the patients regarding diabetes and its complications, unavailability of proper health-care facilities, and late presentation to the hospital.