Diabetic Foot Causes and Outcomes A Study in Wassit Province, Iraq

Abstract

Diabetic foot (DF) as a complication of Diabetes Mellitus (DM) was studied in 88 Iraqi adult patients in Wasit Province at their visit to Al-Karama Teaching Hospital during the period from April 2010 to March 2012.Eighty eight patients were enrolled, 58 males with mean age of 63±8.4 SD years, and 30 females with mean age of 65±4.1 SD years. The mean duration of Diabetes Mellitus was 10.5 years. Uncontrolled hyperglycemia was documented nearly in all patients at presentation.More than 90% of the patients were non-compliant with diet , drugs or both and 88% of them have high body mass index ( BMI >26 Kg/m2) . Other co-morbidities also co-exist, 72.7% of them have peripheral neuropathy (mainly sensory ), 54.5% have hypertension,40.9% of them are active smokers, 39.7% ischemic heart disease, 35% peripheral arterial disease , 34% history of trauma, 29.5% have hyperlipidemia( Table 1). Many of them have more than one risk factor concomitantly. The presenting Diabetic Foot problems were: ulcers in 45 patients, gangrene of the toes and/or the feet in 24 patients, abscess or cellulitis in15 patients and 4 patients presented with miscellaneous conditions (Table 2). Conservative treatment was successful in 95.3% of non-gangrene diabetic foot conditions .But 24 patients who presented with gangrene were in need of some sort of amputation of toes or more proximal ,especially those older than 65 years of age with multiple risk factors. Foot negligence, mis-care, mal-footwear and lack of knowledge about the sequels of diabetic foot by the patient were the main precipitating factors that augment the problem and worsen the outcome. The education programs about Diabetic Foot and correction of risk factors can do a lot to minimize the problem.