Profile Of Diabetic Foot Ulcers Research Articles

129-OR: Increased Triglyceride Levels Are Associated with a Distinct Lipid-Associated Protein Biomarker Profile of Diabetic Foot Ulcers

129-OR: Increased Triglyceride Levels Are Associated with a Distinct Lipid-Associated Protein Biomarker Profile of Diabetic Foot Ulcers

Insights on MDR Mechanism of Pseudomonas aeruginosa with Emphasis on Diabetic Foot Ulcer in the Indian Subcontinent

Diabetic foot ulcers (DFU) in patients with uncontrolled diabetes mellitus are considered a global public health menace that is highly associated with morbidity and mortality. Pathogenic microorganisms entrenched deep into diabetic foot wounds are the causative agents for delayed healing and escalation of diabetic foot wound severity. Pseudomonas aeruginosa is a common opportunistic pathogen associated with several nosocomial infections, cystic fibrosis, and one of the most critical pathogens often isolated from acute and chronic diabetic foot ulcers. The organism can exhibit resistance to a wide range of antibiotics like ciprofloxacin, cefotaxime, and meropenem, thereby causing severe damage to the host tissues, followed by amputation of the affected foot region. Due to their ability to synthesize biofilms, the wound becomes more chronic and incurable, posing a serious threat to immunocompromised diabetic patients. This review highlights on the insights of pathophysiology and microbiological profile of Diabetic foot ulcers, the resistance mechanisms, and the therapeutics available for dealing with drug-resistant Pseudomonas, which could help clinicians in treating DFUs.

Microbial Profile of Diabetic Foot Ulcers of Patients Attending the Regional Hospital Bamenda (Cameroon)

Microbial Profile of Diabetic Foot Ulcers of Patients Attending the Regional Hospital Bamenda (Cameroon)

Immunological profile of diabetic foot ulcers: update review

The most frequent consequence of diabetes mellitus, diabetic foot ulcers frequently do not heal and necessitate lower limb amputation. According to estimates, DFU accounts for 50% to 70% of all lower limb amputations, and 50% of patients with DFU have peripheral artery disease (PAD), which is occasionally brought on by atherosclerosis. Deformity of foot, peripheral artery disease (PAD), loss protective sensation (LOPS), and a history of foot ulcers. Global prevalence for DFUs varies by region. One of the frequent complications of diabetes in poor nations, such as Iraq, is diabetic foot; approximately two-thirds of the patients with diabetes have Diabetic Foot disorder (DFD) in Iraq and this health issue had significant negative social and economic effects. The Saudi Arabia and Bahrain have the highest prevalence rates of DFU; the reported yearly incidence of diabetic foot ulcers ranges from "2.1% to 7.4%". There are three types of diabetic foot ulcers: neuropathic, neuroischaemic, and ischemic. An infected DFU often contains three to five different types of bacteria, including gram-positive aerobes, such as "Staphylococcus sp.", gram-positive anaerobes, gram negative aerobes, gram negative anaerobes, and fungi (Candida spp.). Numerous studies have demonstrated that effective management of DFU can significantly decrease, postpone, or even completely avoid consequences like infection, gangrene, amputation, and death.

Bacterial and fungal profile of diabetic foot ulcer

Introduction: Polymicrobial biofilm in chronic diabetic foot wounds is a major challenge for the treatment and lead to several complications, including increased morbidity, mortality, and limb loss. Methodology: In this study, a spectrum of bacterial and fungal isolates was carried out in 66-foot ulcer samples from diabetic patients. All bacterial isolates were identified by conventional culture methods and biochemical identification tests. Filamentous fungi and yeasts were identified morphologically and by staining methods. Results: Among 66 samples, 62 (94%) samples were culture-positive, and four samples (6%) were culture-negative by the conventional culture method. Polymicrobial growth was found in 11 samples (17%) and monomicrobial in 51 wound samples (77%). Both Gram-positive and Gram-negative bacterial species were isolated. The number of Staphylococcus aureus isolates was more (61%). Fungi were isolated in 4 patients, and all the isolates were identified as Candida tropicalis. Several clinical complications were found including hypertension (47%), osteoarthritis (6%), rheumatoid arthritis (8%), cardiovascular disease (19%), peripheral vascular disease (20%), amputation (35%), foot cramps (71%) and edema (8%). Conclusion: Monomicrobial growth was predominant than polymicrobial growth, and S. aureus was the predominant pathogen isolated. Adequate treatment management of diabetic foot is needed to reduce the risk of amputation.

Bacterial Profile of Diabetic Foot Ulcer with duration and Types of Diabetes and Antibiotic Therapy

Objective: To find out the gram negative bacteria causing the diabetic foot ulcers and most effective antibiotic therapy. Study Design: Cross-sectional descriptive study Place and Duration of Study: Diabetic Center Hayatabad, Kabir Medical College Peshawar from 1st September 2021 to 28th February 2022. Methodology: Sixty nine admitted patients for the treatment of diabetes having type 1 diabetes mellitus and type 2 diabetes mellitus were enrolled. All the patients were on treatment of antibiotic such as gentacin, augmentin, amikacin and clindamycin. The specimens were analyze in microbiology laboratory and extracted by needle aspiration of material from the infected site and inoculate within 1hour after collection using gram staining smear for the detection or cytology of bacteria and its presence and absence in a specimens, for the isolation specimens were plated onto chocolate, phenyl ethyl alcohol (PEA) and MacConkey agar plate. To check the antibiotic susceptibility pattern Kirby Bauer test was performed. Results: There were eight anaerobic gram negative bacteria included in the study. In type 1 diabetes the Escherichia coli extended-spectrum-β-lactamase (ESBL) was 4.8% while in type 2 it was 95.2% in case of Klebsiella oxytoca. There is no bacteria in type1 while in type2, 100% were detected among 13 samples out of 69. E. coli (ESBL) was found in 66.7% in diabetic patients >10 years with foot ulcers while 33.3% in <5 years and Klebsiella oxytoca was 61.5% in >10 years while in <5 years, 23.1% was found in the lesions. In the wound all the presence of E. coli (ESBL) was high as compared to other gram negative bacteria. In antibiotic therapy E. coli was 76.2% were resistant while in Klebsiella oxytoca 69.2% were show resistant while 23.1 % were sensitive while Enterobacter was 100 % and Proteus mirabillus has 50.0% sensitivity. Serratia was 75% resistant and E. colicephalosporin producer were 77.8% resistant to augmentin. The sensitivity of clindamycin was zero percent in all gram negative bacteria. Amikacin is 90.5% sensitive to E-coli and 9.5% resistant while gentacin is 66.7% sensitive and 33.3% resistant to bacteria e-coli. Conclusions: Escherichia coli extended-spectrum-β-lactamase was found to be the most common gram negative bacteria detected in wound of diabetic foot ulcers. Keywords: Escherichia coli, Diabetic foot ulcers, Antibiotic therapy, Sensitivity, Resistant

Bacteriological Profile of Diabetic Foot Ulcers and Detection of Methicillin-Resistant Staphylococcus aureus and Extended-Spectrum β-Lactamase Producers in a Tertiary Care Hospital.

IntroductionDiabetic foot infection is the most dreaded complication of diabetes mellitus and the commonest cause of hospitalization and limb amputation. Identification of the causative agent responsible for diabetic foot infection and the earliest initiation of appropriate antimicrobial therapy are vital for the control and prevention of the complication of diabetic foot ulcers. Therefore, we conducted this study to determine the bacteriological profile of diabetic foot ulcers and to detect methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase (ESBL) producers in our institute.MethodologyDuring the study period, samples were collected from the foot ulcers of 100 patients at the Diabetic Outpatient Department. The samples were processed according to the standard laboratory protocol, and bacterial isolates were identified. Antibiotic susceptibility testing was performed using the modified Kirby-Bauer disk diffusion technique, and results were interpreted according to the Clinical and Laboratory Standards Institute guidelines (CLSI 2016). A phenotypic test for MRSA detection was performed using cefoxitin (30 μg) disk. ResultsThe highest incidence of diabetic foot ulcers was observed in patients aged 41-50 years. There were 83 men and 17 women, with a male to female ratio of 4.882. Of the 100 collected samples, 73 were positive for microbial growth, and 27 samples showed no growth. Of the 73 positive cultures, monomicrobial infection was found in 48 patients, and polymicrobial infection was found in 25 patients. Gram-positive pathogens were isolated from 34 patients, and gram-negative microbes were isolated from 64 patients. Among all collected isolates (n=100), Staphylococcus aureus was the most predominant organism and Acinetobacter species was the least common (only two isolates). Among the gram-negative bacteria, Pseudomonas aeruginosa was predominant. All the isolated gram-positive bacteria were susceptible to vancomycin. Gram-negative bacteria were highly susceptible to colistin with the exception of Proteus species which is intrinsically resistant to colistin and it is not reported for Proteus species. ESBL producers were primarily found among Klebsiella species isolates (22.22%). Among 29 S. aureus isolates, 8 (27.5%) were found to be MRSA producers.ConclusionBased on the bacteriological profile of diabetic foot ulcers, S. aureus among the gram-positive isolates and P. aeruginosa among the gram-negative isolates were the predominant pathogens. Infections caused by multidrug-resistant bacteria such as MRSA and ESBL producers have been reported with increasing frequency. According to the antibiotic susceptibility pattern, treatment can be initiated, continued, or altered, thereby reducing morbidity in patients with diabetic foot ulcers.

Clinical and microbiological profile of diabetic foot ulcers in a tertiary care setup: a cross sectional analysis

Background: Diabetes associated neuropathy and vasculopathy leads to development of diabetic foot ulcers (DFU). They are responsible for considerable morbidity and a significant cost of health‐care worldwide. The magnitude of the problem becomes worse in regions where foot care is inadequate like in our country. The aim of the study to determine the microbiological profile and antimicrobial susceptibility pattern of organisms isolated from patients with diabetic foot ulcers. Methods: The study was a cross sectional study done at King George’s Medical College, Lucknow from 2012-2014 in Lucknow, Uttar Pradesh. Based on the inclusion criteria sample were collected from 112 patients. The standard protocol for the identification of microorganisms was followed. A descriptive analysis of the data was done.Results: Out of the 112 ulcers total 180 isolates were found. Of the 112 cases, 78 were monomicrobial, 32 were polymicrobial, and 2 cases were sterile on culture. The most common bacteria found was Staphylococcus aureus. Most of the staphylococcus isolated were sensitive to vancomycin, teicoplanin, cephalosporins, linezolid levofloxacin and pipercillin-tazobactum. Nearly 65% of S. aureus were methicillin‐resistant S. aureus.Conclusions: This study compiled clinical and microbiological profile of diabetic foot ulcers along with their antibiotic susceptibility patterns. Our study illuminates light on a high figure of neglected and poorly treated NHUs which could have been managed well and early treatment will prevent devastating consequences such as sepsis and amputation.

Microbiological profile of diabetic foot ulcers in Kuwait.

Diabetic foot ulcers (DFU) and infection (DFI) are a major diabetes-related problem around the world due to the high prevalence of diabetes in the population. The aim of our study was to determine the microbiological profile of infected ulcers in patients attending Dasman Diabetes Institute (DDI) clinics in Kuwait and to analyze the distribution of microbial isolates according to wound grade, sex, age and diabetes control. We collected and analyzed clinical data and samples from 513 diabetic patients with foot ulcers referred to our podiatry clinic at DDI from Jan 2011 till Dec 2017. We show a higher prevalence of DFU in men than in women, and a greater percentage of DFU occurred in men at an earlier age (p<0.05). Only about half of the DFU were clinically infected (49.3%) but 92% of DFU showed bacterial growth in the microbiological lab analysis. In addition, we isolated more monomicrobial (57.3%) than polymicrobial (34.8%) DFI and representing an average of 1.30 pathogens per patient. The presence of Gram-positive and Gram-negative strains was comparable between men and women regardless their age or glucose levels. Interestingly, more Gram-positive strains are present in ulcers without ischemia while more Gram-negative strains are present in ulcers with ischemia (p<0.05). While Staphylococcus aureus was common in infected ulcers without ischemia, Pseudomonas aeruginosa was predominant in ulcers with infection and ischemia, regardless of ulcer depth. Finally, a higher percentage of women has controlled HbA1c levels (19.41% versus 11.95% in men) and more women in this group displayed non-infected wounds (60.6% and 43.90% for women and men, respectively). Our results provide an updated picture of the DFI patterns and antibiotics resistance in patients attending Dasman Diabetes Institute (DDI) clinics in Kuwait which might help in adopting the appropriate treatment of infected foot and improving clinical outcomes.

A study on clinical grading and bacteriological profile of diabetic foot ulcers in tertiary care centre

Background: Diabetes is one of the commonest diseases worldwide and diabetic foot ulcer and its complications are associated with significant morbidity and even amputation. Early detection of colonizing agent of these ulcers help in reduced morbidity and hospital stay. We targeted this subgroup of patients to study Wagner’s grade, identify the bacterial agent and its antibiotic sensitivity and ankle-brachial pressure index (ABPI) assessment to detect PAD, for the best treatment outcome of diabetic foot ulcers.Methods: The present study was conducted in the Department of Surgery of SGMCRF, Venjaramoodu on 210 patients with diabetic foot ulcers between November 2017 and May 2019. Wagner’s grading of ulcer, culture and antibiotic sensitivity of microbe were done as well as ABPI was measured. Outcome of ulcers was compared to ABPI and ABPI was compared to time of healing.Results: Out of 210 patients 122 were males and 88 females, 62.9% had neuropathy and 66.7% had vasculopathy. Most patients presented with Wagner’s grade-II ulcers. Most common microbe isolated was pseudomonas aeruginosa which was most sensitive to piperacillin and tazobactam combination. Majority of lesions 62.9% had ABPI in range of 0.5-0.89.Conclusions: Wagner’s grading and presence of neuropathy are predictors of major amputation. Piperacillin and tazobactam should be empirical choice of antibiotic. ABPI was inversely related to time of healing and has got significant association with treatment outcome.

Clinico-microbiological Profile of Diabetic Foot Ulcers at a Tertiary Care Hospital of Odisha

Clinico-microbiological Profile of Diabetic Foot Ulcers at a Tertiary Care Hospital of Odisha

Management of Diabetic Foot Ulcer in a Tertiary Level Hospital-Faridpur

A descriptive type of cross sectional study among 210 diabetic patients with foot ulcer was carried out in Diabetic Association Medical College during the period of May 2016 to April 2017 and were categorized based on Meggitt-Wagner system to find out the complications, management, below knee amputation rate and mortality rate. The aim of this study was to practise a profile of diabetic foot ulcer (DFU), complications and its management to assess the outcome of the surgical interventions. Majority of the patients were male 112(53%), and most of them 116 patients (55.23%) presented within Wegner grade - 2 and grade-3 diabetic foot ulcers. The duration of diabetes more than 10 years was 116 (55%). 99 (47%) patients out of 210 patients developed diabetic neuropathy. 76 (36%) patients presented with CKD. Lack of awareness about diabetes mellitus and its lower limb complications, poor compliance to the treatment, poorly controlled blood sugar levels, delay in diagnosis, and late presentation to the tertiary care center, associated habit of smoking are all factors which lead to incidence of DFU at an earlier age than that seen in other studies. After admission of diabetic foot ulcer patients, diabetic foot ulcer is classified according to Wagner grading and treated the diabetic foot ulcer patients as the using protocol ’!1.Assesment whether it was conservative or surgical. 2. Optimal blood sugar control. 3. Systemic antibiotic. 4. Moist wound environment. 5. Offloading such as total contact casting. 6. Improves peripheral arterial circulation due to lack of vascularity. 7. Surgical debridement or minor amputation or major amputation. In case of G-4 or G-5 patients, ischemia was treated before debridement or amputation so that vascular circulation improved in the ulcer area and then healing potential was fastened.&#x0D; Bangladesh Heart Journal 2019; 34(1) : 52-57

Bacteriological profile of diabetic foot ulcers

Background: Foot infections are the major complications of diabetes mellitus and lead to the development of gangrene and ultimately amputation of the limb. Proper diagnosis of the causative agents and their antibiotic susceptibility play a significant role in preventing adverse prognosis of diabetic foot. Aim: The study aims to establish the bacteriological profile of diabetic foot ulcers as well as to note resistance pattern of the implicated organisms. Materials and Methods: One hundred and forty-eight patients having diabetic foot ulcers of Wagner's Grade 1 or above were included in this study. Debrided tissue, pus, or swabs from the base of the ulcers were subjected to aerobic and anaerobic culture. The organisms were identified, and further antibiotic sensitivity of the aerobic bacteria was conducted by Kirby–Bauer's disc diffusion method. Results: Two hundred and forty aerobic and 21 anaerobic bacteria were isolated from these ulcers; Staphylococcus aureus and Bacteroides spp. are the most common aerobic and anaerobic bacteria isolated, respectively. Of the S. aureus, 77.8% were methicillin resistant, while 42.1% of the Gram-negative Enterobacteriaceae were extended-spectrum beta-lactamase (ESBL) positive. Klebsiella spp. was the highest ESBL producer whereas Acinetobacter spp. was the highest metallo-beta-lactamase producer. Linezolid, teicoplanin, and vancomycin were the most sensitive drugs for Staphylococcus spp. Gram-negative isolates were mostly sensitive to cefoperazone-sulbactam and imipenem. Pseudomonas spp. was mostly sensitive to imipenem and piperacillin-tazobactam, whereas Acinetobacter spp. was sensitive to netilmicin and levofloxacin. Conclusion: As diabetic ulcers are often infected by multidrug-resistant bacteria, a knowledge of the common bacterial pathogens implicated as well as their sensitivity pattern helps the clinician to choose the proper antibiotic for a timely treatment.

Clinico-Microbiological Profile of Diabetic Foot Ulcer: The common Anatomical site

Clinico-Microbiological Profile of Diabetic Foot Ulcer: The common Anatomical site

Bacteriological Profile of Diabetic Foot Ulcer with Special Reference to Drug-resistant Strains in a Tertiary Care Center in North-East India.

Aim:This study was carried out to determine the bacteriological profile of infected diabetic foot ulcers (DFUs) and the antibiotic resistance pattern from the isolates. An attempt was made to suggest an empiric antibiotic regimen to treat such patients.Materials and Methods:Tissue samples were collected from 150 patients between February 2015 and January 2016 with DFUs under aseptic precautions and they were processed as per the Clinical and Laboratory Standards Institute guidelines.Results:A total of 185 bacterial isolates were obtained from 150 persons with diabetic and with foot ulcers. The age group of these persons ranged from 35 to 80 years and the maximum number of persons with DFUs was in the age group of 60–65 years. Among the isolates, Gram-negative bacilli were isolated in 112/185 (61%) and Gram-positive cocci in 73/185 (39%) cases. The most common isolate was Staphylococcus spp. 46 (25%), followed by Escherichia coli (20%) and Enterococcus spp. (15%). The antibiotic sensitivity profile of the bacteria was also studied. Among the isolates, 59/112 (53%) of the Gram-negative bacilli were extended spectrum beta-lactamase producers, 19/46 (41%) were methicillin-resistant Staphylococcus aureus, and 5/27 (19%) were vancomycin-resistant Enterococcus.Conclusions:This study showed a preponderance of multidrug-resistant strains among the isolates from the DFUs. Knowledge on the antibiotic sensitivity pattern of the isolates will be helpful in determining the drugs for the empirical treatment of diabetic ulcers. Thus, indiscriminate use of antibiotics and chances of subsequent development of antibiotic resistance can also be reduced.

English

Background: Worldwide diabetic foot is a major medical problem leading to disability and economic instability to family and country. Objectives: To assess the clinical and bacteriological profile of diabetic foot ulcer among rural Indian residents. Also to know the prevalent pattern of antimicrobial resistance of most commonly isolated organisms to various currently in use antimicrobial agents. Methodology: From 78 cases of diabetic foot ulcer, identification of isolates was done using standard microbiological techniques. Antibiotic sensitivity testing were carried out followed by detection of ESBL, MRSA, AmpC and MBL producing strains as per the CLSI guidelines. Results: In our study, a total of 78 specimens were cultured and 97.4% ulcer showed growth of organisms (76/78). Of the total 139 isolates, 134 (96.4%) were aerobes and only 5 (3.6%) isolates were anaerobes. An average of 1.8 organisms per lesion was isolated. Among the aerobes, 93 (69.4%) gram negative and 41 (30.6%) gram positive organisms were isolated. Pseudomonas aeruginosa 23.9% was predominant organism followed by Klebsiella species (20.9%). A total 41 (30.6%) aerobic gram positive bacteria were isolated. Staphylococcus aureus was the most common gram positive organism 28.4% in which Methicillin resistant S. aureus (MRSA) was 57.9%. Among gram negative organisms 46(49.5%) isolates showed ESBL production. Among ESBL producing strains Escherichia coli 68.3% isolates recorded highest ESBL activity followed by Pseudomonas aeruginosa 62.5 % and Klebsiella species 53.6 %. Conclusion: The present study has shown that diabetic foot infections are polymicrobial in nature and commonly caused by multi drug resistant gram negative organisms.

Bacterial Profile of Diabetic Foot Ulcers of Patients Visiting a Specialist Diabetic Clinic at Komfo Anokye Teaching Hospital, Kumasi, Ghana

Aims: Diabetic foot ulcers (DFU’s) pose socio-economic challenges and are a major cause of hospital admissions and morbidity often causing suffering and poor quality of life for diabetics especially in developing world. The aim of this study was to determine the bacterial profile and antibiotic susceptibility and resistance pattern of foot ulcers of diabetics at Komfo Anokye Teaching Hospital (KATH). Study Design: Descriptive cross-sectional. Twenty seven (27) diabetics with foot ulcers comprising 15 males and 12 females attending the diabetic clinic at KATH were recruited

Clinico-bacteriological profile of diabetic foot ulcer among the patients attending rural tertiary health care centre

Background: Worldwide diabetic foot is a major medical problem leading to disability and economic instability to family and country. Objectives: To assess the clinical and bacteriological profile of diabetic foot ulcer among rural Indian residents and its association with demographic factors. Methodology: Hospital based cross-sectional study was carried out in the rural tertiary care centre during the year 2010 to 2012. A total 78 diabetic foot ulcer cases were enrolled, interviewed, clinica lly examined and bacteriological assed as per structured questionnaire and methods. Results: Maximum, 70.51% cases were above the age of 50 years with higher proportion, 76.9% seen in males. The majority of cases, 97.4% were belonged to type II DM with maximum, 48.7% cases had a duration of ulcer less than of ten days. Maximum, 67.94% ulcers were seen on Right foot, 53.8% ulcers were of grade III and above. Neuropathy, the major associated complication was seen in 68% cases and average 1.8 bacteria were identified per sample. Conclusion: As the grade of diabetic foot ulcer is increased, the bacterial count is also increased.

Microbiological profile of diabetic foot ulcers and its antibiotic susceptibility pattern in a teaching hospital, Gujarat

Background: Diabetic foot lesions are a major medical, social and economic problem and are the leading cause of hospitalization for patients with diabetes worldwide. Infection sometimes leads to amputation of the infected foot if not treated promptly. The present study was conducted to isolate and identify the bacterial pathogens associated with diabetic foot ulcer and to find out its antibiotic susceptibility pattern to reduce the risk of complications. Methods: Total 100 pus samples were collected from patients having diabetic foot ulcer, during July to October 2012. Samples were processed as per standard guidelines. Results: Out of 100 pus samples, 73 (73%) yielded growth of organisms making total of 92 isolates. Out of 92 bacterial isolates, 72 were gram negative and 20 were gram positive. Pseudomonas aeruginosa 25 (27%) was most common isolate causing diabetic foot infections followed by 20 (22%) Klebsiella sp. , 17 (19%) E. coli , 15 (17%) S. aureus , 6 (7%) Proteus sp. and 4(3%) Enterococc i, 2 (2%) Acinetobacter sp. and 2(2%) CONS and 1(1%) Providencia . Out of 72 GNB, 50 (69.4%) were extended spectrum β lactamase (ESBL) producer. Most gram negative isolates were resistant to levofloxacin, gentamicin, ampicillin-sulbactam and gatifloxacin. All GNB were sensitive to imipenem. Out of 15 S. aureus, 9 (60%) were Methicillin Resistant Staphylococcus aureus (MRSA) and were sensitive to vancomycin and linezolid. Conclusions: Pseudomonas sp . was the most common cause of infections. Most isolates were multi drug resistance.

Diabetic Foot Ulcer Complications and Its Management-a Medical College-Based Descriptive Study in Odisha, an Eastern State of India.

The aim of this study was to prepare a profile of diabetic foot ulcer (DFU) complications and its management and to assess the outcome of the surgical interventions. A prospective study was carried out in 60 patients with DFU during the period of January 2009 to October 2010 to categorize them based on Meggit-Wagner system and to find out the complications, management, below knee amputation rate, and mortality rate. Majority of the patients (30%, n = 18) presented with Wegner grade 3 DFU. Only three patients (5%) presented with grade 0 DFU. Split skin grafting was the most frequently done intervention, comprising 29% of the time. Below knee amputation was required in 10% of cases and mortality rate was 12%. Lack of awareness about diabetes mellitus and its lower limb complications, poor compliance to the treatment, poorly controlled blood sugar levels, delay in diagnosis, and late presentation to the tertiary care center are all factors which led to occurrence of DFU at an age earlier than that seen in other studies.