Abstract
AimThe present study aimed: (1) to evaluate the proportion of each diabetic foot (DF) risk category, according to the International Working Group on the Diabetic Foot (IWGDF) consensus, in patients attending the diabetic clinic in Selebi Phikwe Government Hospital (SPGH) and (2) to examine some of the factors that may be associated with the progression to higher risk categories such as anthropometric measurements, blood pressure, glycosylated haemoglobin (HbA1c) and lipid profile.MethodsA retrospective, cross sectional chart review of patients who had attended the diabetic clinic in SPGH from January 2013 to December 2013 was performed. Patients were included if they had undergone a foot examination. Patients with amputation due to accident were excluded. The DF risk category was assessed by determining the proportion of patients in each of four risk categories, as described by the IWGDF consensus.ResultsThe study encompassed 144 records from patients reviewed for foot examination from January to December 2013. Patients’ ages were between 16 and 85 years, 46 (40%) were male and 98 (60%) were female. The majority (122, [85%]) of patients were in DF risk category 0, whilst a limited number of patients were classified in risk category 1 (10, [6.9%]), risk category 2 (7, [4.9%]) and risk category 3 (5, [3.5%]). Most of the patients had the type 2 diabetes mellitus (139, [97%; 95% CI 92% – 99%]). Patients’ ages were associated with the progressively higher DF risk categories. The adjusted odd ratio was 1.1 (95% CI 1.03-1.14; p = 0.004).ConclusionThe present study revealed that about 15% of patients attending the SPGH diabetic clinic were categorised in higher risk groups for diabetic foot; patients’ ages were linked to the higher DF risk categories.
Highlights
Lower limb problems such as foot ulceration, infection and amputation are common in people with diabetes. 1,2,3,4,5 Recent reports have highlighted the significance of prompt recognition of the http://www.phcfm.org doi:10.4102/phcfm.v6i1.610high-risk foot and the standardised provision of preventive measures, 6,7 as they can help to avoid the development of foot lesions, minimise morbidity and costs resulting from those complications
The aim of the present study was: (1) to evaluate the proportion of each diabetic foot (DF) risk category, according to International Working Group on the Diabetic Foot (IWGDF) consensus,[4] in patients attending a diabetic clinic in Selebi Phikwe Government Hospital (SPGH), a district primary care facility in Botswana; and (2) to examine some of the factors that may be associated with the progression to higher risk categories such as anthropometric measurements, blood pressure, glycosylated haemoglobin (HbA1c) and lipid profile
149 patients were included in the present study because they were reviewed for foot examination from January to December 2013
Summary
High-risk foot and the standardised provision of preventive measures, 6,7 as they can help to avoid the development of foot lesions, minimise morbidity and costs resulting from those complications. Strategies such as patient and staff education, multi-disciplinary management of foot ulcers, and close monitoring can lessen the amputation rate.8, 9.10,11. High risk of foot complications is associated with: a history of prior ulcer or amputation, Charcot foot, poor glycaemic control, trauma, peripheral neuropathy and/or peripheral vascular diseases, infections, foot structure deformity, impaired vision, old age, male gender, and ethnicity (black people and Hispanic people).[4, 12, 13, 14]. In risk category 3, patients have a history of plantar ulceration or neuropathic fracture (Charcot foot). 4, 12, 15 Risk stratification serves as a guide to schedule patient review; risk category 0, 1, 2 and 3 patients are reviewed annually, semi-annually, quarterly and monthly to quarterly, respectively.[4]
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