Evaluation of age and peripheral vascular disease as risk factors for diabetic foot ulceration among Nigerian patients without foot ulcers.

Abstract

Background and Objectives : Risk factors predisposing to foot ulceration in diabetic subjects are multiple. Age and peripheral vascular disease are recognized risk factors for foot ulceration among diabetes mellitus subjects. Objectives : To evaluate the effect of age and peripheral vascular disease as risk factors for foot ulceration in Nigerian diabetic subjects without current or previous foot ulceration. Subjects and methods : One hundred and twenty (120) diabetic mellitus (DM) subjects receiving care at the medical outpatient department (MOPD) and the diabetic clinic of the Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria, were recruited consecutively as they presented. Data collected included subjects age (years), gender, age at first diagnosis of DM, duration of DM (years) and baseline fasting venous plasma glucose. The subjects were evaluated for peripheral vascular disease using clinical criteria (absence of distal pedal arterial pulsations) and by the hand-held Doppler ultrasound device to determine the Ankle Brachial Index (ABI) and the Quality of Doppler Signal (QDS). Results : Among the 120 diabetic participants, peripheral vascular disease (PVD) was detected only in those aged 50 years and above and all the three diagnostic methods detected PVD increasingly with advancing age. Clinical criteria detected PVD in 4.7% of those aged 50-59 years and 26.3% of those aged .70years. For the same age groups ABI detected PVD in 9.3% and 26.3% and QDS 0.0% and 26.3% respectively. Conclusion : Age and peripheral vascular disease are risk factors for foot complication in Nigerians with diabetes mellitus. Elderly diabetic subjects should be recognized as a special group at high risk for foot disease from DM and specific preventive programs should target this group to reduce morbidity and mortality from avoidable loss of limbs to diabetes.