Ulceration of the foot is a major problem for people with diabetes. In a developing country like Nigeria, huge challenge is caused by diabetes foot problems. The aim of this study was to determine the impact of diabetic foot care education of patients and health care staff on the outcome of diabetic foot complications in our hospital. This was a pre and post design carried out from April 2013 to March 2014 on 155 diabetes patients. Patient education was carried out by diabetes nurses and doctors, at diagnosis and re-enforced at follow-up clinics. At the end of 1 year, the impact of education was assessed. Descriptive statistics were generated as appropriate. A total of 155 patients, 64 (41%) males and 91 (59%) females, were studied with mean age of 49 ± 3 years and mean duration of diabetes 6 ± 2.6 years. At the onset of the program, 70% of the patients had no knowledge of foot care education. Only 13.5% knew that diabetes mellitus foot ulcer could be related to long duration of diabetes, nerve damage, blood vessel blockage, foot deformity, and uncontrolled blood glucose. Ninety-two percent of the patients preferred home remedies, herbal treatment, or chemist in the event of an ulcer. After the program, 77% would seek hospital care as first option, and amputation rate decreased from 50% in 2009 to 10% by 2017. Our experience has shown that education is the cheaper option for the prevention of lower limb amputation in a resource-poor setting like ours.

BackgroundWaist-height ratio (WHtR) is increasingly being studied as a simple and effective measure of central obesity. Reports have shown that WHtR is a better predictor of hypertension, diabetes, and cardiovascular diseases when compared to traditional obesity indices like body mass index (BMI), waist circumference (WC), and waist-hip ratio (WHR). This study is therefore aimed at comparing WHtR with other obesity indices in the prediction of peripheral neuropathy in persons with diabetes mellitus (DM).MethodologyOne thousand and forty persons with DM were enrolled following consent. Relevant details of history were obtained, followed by physical examinations. Data were analyzed using IBM-SPSS version 23. Logistic regression was used to compare the odds ratio of obesity indices in the prediction of peripheral neuropathy. The level of significance used was p = 0.05.ResultsLogistic regression showed that WHtR had the highest odds ratio (OR) for the prediction of “probable” diabetic peripheral neuropathy (OR 9.11, 95% CI 3.07–47.97, p = 0.002), followed by WC (OR 2.01, 95% CI 1.09–4.05, p = 0.004), and BMI (OR 1.26, 95% CI 1.00–3.99, p = 0.019) after correction for age; systemic hypertension; duration of DM; control of SBP, DBP, HbA1c, FPG, and 2HrPP.ConclusionWHtR has the highest odds ratio in the prediction of “probable” diabetic peripheral neuropathy in both genders, followed by WC in the males and BMI in the females.

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Background: Peripheral neuropathy is one of the microvascular complications of diabetes mellitus, a risk factor for diabetic foot, and a major cause of disability world wide. Several authors have variedly reported on the efficacies of the different simple and sophisticated methods used in the diagnosis of peripheral neuropathy. The aim of this study is to compare the diagnostic yields of different simple methods of screening for diabetic peripheral neuropathy. Methodology: This is a multi-center cross-sectional study involving 1040 participants recruited consecutively, following consent. Relevant biodata and medical history were obtained, while physical examinations including anthropometry, and blood glucose levels were done for each participant. History of paresthesia, 10g monofilament test, vibration test using 128Hz tuning fork, and ankle reflex assessment were the methods used to screen for diabetic peripheral neuropathy. Student ‘t’ test and chi square were used to compare continuous and categorical variables respectively. Significant p-value was put at less than or equal to 0.05. Results: The percentage of participants with positive screen for diabetic peripheral neuropathy based on the different methods include: positive neuropathic symptoms (64%), negative neuropathic symptoms (50.7%), 10g monofilament testing (31.9%), vibration sensation by tuning fork (21.8%), and ankle reflex impairment (13.1%). A total of 80.1% of the participants were screened positive for diabetic peripheral neuropathy when all the methods were used. Conclusion: Positive and negative neuropathic symptoms have higher diagnostic yields for diabetic peripheral neuropathy screening than 10g monofilament testing, vibration sensation using tuning fork, and ankle reflex examination. However, it is encouraged to use all available methods to screen for diabetic peripheral neuropathy, as this increases the diagnostic yield, and ensure early adoption of preventive and therapeutic strategies.