Abstract
Background : Diabetic foot ulcer is a common long term complication of diabetes and the most common cause of non-traumatic amputation and prolonged hospitalization. These increases disease burden and further worsen quality of life. Aim : This study evaluated exposure risk factors for foot ulcers among diabetics attending a secondary healthcare facility in Southwest Nigeria. Methods : A case control study of exposure risk factors for diabetes foot ulcer (DFU) at General Hospital Marina Lagos. Using a structured interviewer administered questionnaire, information on foot care education, 24-hour dietary recall, medical history, anthropometric indices and social habits of participants were obtained and analyzed. Results : There were 636 participants in this study (106 cases and 530 controls) with median age of 61.1±11.0 years in both study groups and mostly females, (75.5% in cases and 78.7% controls) with female to male ratio of 3:1. Majority, (83% in cases and 85% in controls) were in the low socioeconomic class and had lived with DM for more than 5years. Of the studied risk factors, lacking foot care education, diagnosis of visual impairment and hypertension, dietary intake of large proportion of carbohydrate meal at breakfast and dinner and obesity occured in significantly higher proportion of cases and controls and were associated with presence of DFU. (p<0.05) Conclusions : Lack of foot care education, diagnosis of visual impairment, hypertension and poor dietary habit are associated with presence of DFU. Addressing these factors from point of diagnosis will go a long way in stemming the burden of diabetes foot ulcer. Funding: Self-funding. Keywords: Diabetes, foot ulcer, exposure risk factors, Southwest Nigeria.
Highlights
Diabetic foot Ulcer (DFU) is the most common chronic complication in persons with diabetes depending on disease duration and successful management.[1,2,3] About 25% of persons with diabetes mellitus (PWDM) will develop DFU while 5% to 15% will be treated for foot or leg amputation in a lifetime.[4]
This study evaluated level of foot care education, past medical history, social and dietary habits with obesity as DFU risk factors among PLWD at a secondary health facility setting in Nigeria with aim to instituting appropriate measures of prevention to minimize DFU prevalence, burden and poor quality of life
The use of body mass index (BMI) and waist circumference (WC) as measures of obesity in this study showed that 88.7% of cases and 77.9% of controls using BMI, were overweight and obese using their BMI, a statistically significant difference (p
Summary
Diabetic foot Ulcer (DFU) is the most common chronic complication in persons with diabetes depending on disease duration and successful management.[1,2,3] About 25% of persons with diabetes mellitus (PWDM) will develop DFU while 5% to 15% will be treated for foot or leg amputation in a lifetime.[4]. Established risk factors for DFU include peripheral sensory neuropathy, peripheral arterial occlusive disease, structural foot deformity and unintentional or imperceptible trauma in the presence of insensate feet.[2,9]
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