English

Abstract

CONTEXT: Foot complications are one of the most serious and costly complications of diabetes, but are usually neglected. Since most Indians still walk barefoot and are ignorant of foot care, there is an urgent need for preventive clinical measures to reduce the impact of diabetic foot. AIMS: To evaluate micro and macro vascular complications in diabetics as predictors of diabetic foot risk. SETTINGS & DESIGN: The study was conducted in Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital, Rewa (MP), in 2013 on 200 diabetics. METHODS & MATERIAL: A complete general and systemic examination to be carried out on diabetic subjects, analysing their micro and macrovascular complications and evaluating their risk of developing diabetic foot. Data analysis was done by calculating the p-value using the Chi Square Test. RESULTS: Out of 200 patients, 12 were at a high risk of developing diabetic foot, while 57 and 131 were at low and moderate risk respectively. Demographic profile revealed a higher risk among the older population (p=0.0003), low Socioeconomic strata (p=0.007), rural population (p=0.006) and a lower risk among the literate (p=0.01) and with a shorter history of duration of diabetes (p=0.02). The presence of retinopathy (p=0.01), nephropathy (p=0.02), neuropathy (p=0.0006), and periodontal disease (p=0.006) was significant in those with high risk as was the presence of coronary artery disease (p=0.04), hypertension (p=0.02) and peripheral arterial disease (p=0.0005). Other factors, such as blood glucose control (p=0.0002), waist circumference (p=0.04) and various addictions, were also contributory factors to the risk of diabetic foot. CONCLUSION: Diabetic foot is an advanced complication of diabetes from where there is no turning back. The evaluation of risk factors that contribute to it, also serve as intervention points - their control can retard the development of diabetic foot. Thus, this study reveals such factors, detectable through clinical measures and may be the potential solution of impeding the progress of diabetic foot.