Epidemiology of diabetic foot complications in a podiatry clinic of a tertiary hospital in South India

Abstract

Introduction: The prevalence of diabetes is increasing worldwide resulting in foot complications, which leads to poor quality of life and increased cost of living. Aim: The main aim of this study was to find out the foot complications in diabetic patients and to analyze the underlying etiology. Methodology: A retrospective study was carried out in the podiatry Department of Amrita Institute of Medical Sciences, Kerala among 277 diabetic patients with recent and recurrent foot complications. Results: Systemic hypertension (76.89%) has been found to be one of the major risk factor coexisting in the study population. 49.45% patients had preexisting peripheral neuropathy and non-healing ulcers were seen in 41.51%. Other complications include charcot arthropathy (10.46%), gangrene (9.38%), cellulitis (7.94%), fungal infections (6.89%), callus (3.61%), osteomyelitis (3.97%), and necrotizing fasciitis (2.52%). Culture report on foot ulcer patients revealed that Gram-positive Staphylococcus species (18.8%) and the Gram-negative Pseudomonas species (18.2%) were the predominant organisms. Other organisms isolated were Klebsiella species, Escherichia coli, Acenetobacter, Proteus, Enterococcus species, and streptococci. Fluoroquinolones were the most commonly prescribed antibiotics (33.5%), followed by penicillin (8.3%), clindamycin (6.1%), carbapenems (5.05%), cephalosporins (2.8%), cotrimoxazole (2.5%), and chloramphenicol (0.7%). Conclusion: The study highlights the importance of foot care, relevance of early detection of diabetes and subsequent monitoring of diabetic complications.