Study of Risk Factors for Foot Ulceration in Type 2 Diabetes Mellitus Patients with Special Reference to HBA1C

Abstract

Background And Objectives:India, one of the largest countries in the Southeast Asian region, has more than 67 million people with diabetes. With an aging population and the increase in prevalence of DM in the younger age group, the secondary complications are common. Foot problems in diabetes needs increasing attention in view of the fact that they account for 85% of the non- traumatic lower extremity amputations and cause significant morbidity and mortality. The aim is to study the risk factors for foot ulceration in type 2 DM patients in Basaveshwara Teaching & General Hospital (BTGH), Gulbarga. and to educate patients with risk factors regarding foot care. Methods:A total of 50 type 2 DM patients from Basaveshwara Teaching & General Hospital (BTGH), Gulbarga over a period of 1 year formed the study population. Detailed clinical examination including of the feet was done. Risk factors were assessed by l0g/5.07 monofilament and ABI (ankle brachial index) for peripheral sensory neuropathy and peripheral vascular disease respectively . Glycemic control was assessed by HBA1c. Results:The prevalence of neuropathy, PVD, foot deformities are 48.0%, 16.0%, 18.0% respectively. 6.0% had a history of previous ulcer or amputation. 64.0% are unaware that diabetes can cause foot problems and 56.0% of the study population walk bare foot. Statistically significant association (P<0.05) was found between increasing duration of diabetes, worsening glycemic control, increasing age and the prevalence of neuropathy, PVD and foot deformities. Interpretation And Conclusion :Use of simple screening techniques such as monofilament testing and ABI can help in identifying the foot at risk. Patient education, glycemic control, and regular foot examination by a trained health professional can prevent the occurrence of foot ulcers and amputations.