A study on the impact of smoking and alcoholism as determinant factors in the prognosis and outcome of diabetic foot ulcer disease

Pal, Bikramjit; Raveender, Nagaraju; Sudipta, Pal

doi:10.18203/2320-6012.ijrms20161257

Cited by 11 publications

(11 citation statements)

References 10 publications

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“…This is alarming because many of the patients suffered severe infections from multi-resistant pathogens, a result that is similar to that of other studies [45,46]. …”

Section: Discussionsupporting

confidence: 81%

Clinical and surgical characteristics of infected diabetic foot ulcers in a tertiary hospital of Mexico

Cervantes-García

Salazar-Schettino

2017

Diabetic Foot & Ankle

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Background: The objective of this study was to determine the clinical and surgical characteristics of diabetic foot ulcers in a tertiary level hospital in Mexico. Methods: We performed a longitudinal, descriptive study from July, 2012 to August, 2015 on a sample composed of 100 patients with type 2 diabetes mellitus and infected diabetic foot ulcers. We analyzed socio-demographic variables, comorbidities, characteristics of ulcers, and the applied treatment. Results: We found that the most affected areas were the forefoot (48%) and the plantar region (55%) of the foot. Also, most of the patients arrived with advanced stages of diabetic foot ulcers, since 93% of the lesions were of grades III–V according to the Wagner classification. Moreover, lesions usually present with advanced states of infection, since 60% of the lesions were of grades 3–4 in the PEDIS scale. In addition, the great majority of the patients are prone to complications because we found that 43% of the patients suffered from hypertension, 47% of the patients had chronic kidney disease, and 45% reported smoking. In fact, 45% of the patients eventually suffered an amputation. We also found that the situation is more difficult because the great majority of the patients (96%) have a low level of education and very low income and they do not have any health insurance. Nevertheless, we also found that an efficient treatment can help in avoiding amputations, since 53% of grade IV and 25% of grade V lesions according to the Wagner system did not suffer an amputation. Conclusions: Therefore, an effective antibiotic treatment and an education of the patient on the adequate care of their lesions are essential in increasing the welfare of patients, especially when they have a low level of education.

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“…This is alarming because many of the patients suffered severe infections from multi-resistant pathogens, a result that is similar to that of other studies [45,46]. …”

Section: Discussionsupporting

confidence: 81%

Clinical and surgical characteristics of infected diabetic foot ulcers in a tertiary hospital of Mexico

Cervantes-García

Salazar-Schettino

2017

Diabetic Foot & Ankle

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“…A higher DFU frequency was reported in male diabetic patients in several studies (7,12,20). Some studies have shown that men are at greater risk of DFU due to having a higher rate of risk factors leading to DFU such as smoking, peripheral vascular diseases, limited joint mobility, poor glycemic control, and poor medication adherence (7,13,14). Thus, it seems that the higher prevalence of unhealthy behaviors is the main cause of sex-related differences.…”

Section: Discussionmentioning

confidence: 96%

“…This study showed that smoking patients had a higher DFU frequency than non-smoking patients (30.7% vs. 10.3%) and the odds of DFU occurrence were 3.8 times higher in smoking diabetic patients than in non-smoking patients. It is well established that serious factors play an important role in developing DFU, such as decreased blood flow in extremities, peripheral angiopathy, and peripheral neu- ropathy, that are more common in smokers (13,25,26). Furthermore, some studies have reported that smoking aggravates glucose hemostasis and accelerates the onset and progress of microvascular and microvascular diabetes complications (27,28).…”

Section: Discussionmentioning

confidence: 99%

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Frequency of Diabetes Foot Ulcer and Related Factors Among Adult Diabetic Patients in the Diabetes Center of Kerman, Iran

Khalooei

Meymand

2019

Shiraz E-Med J

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Background: Diabetic Foot Ulcer (DFU) as one of the main complications of diabetes mellitus has serious outcomes such as infection, foot amputation, low quality of life, and premature death. Objectives: This study was conducted to assess the DFU prevalence and its related factors among diabetic patients. Methods: The population of this cross-sectional study included adult diabetic patients in the Diabetes Center of Kerman University of Medical Sciences. The data were recorded in a questionnaire using patients' medical records, interviews with them, and physical examination. The collected data were imported to SPSS version 22 software and analyzed. Results: Of 400 diabetic patients enrolled in the study, 69% (n = 276) were female. The mean (± SD) of their age was 57.1 (± 11.9) years and 72% (n = 288) were younger than 65. The frequency of DFU during the total course of the disease and its annual prevalence were 17.3% (n = 69) and 11.8% (n = 49) among diabetic patients, respectively. More than one-third (37.7%) of the DFU patients and 6.6% of all the patients were admitted to a hospital due to DFU. Major or minor amputation was performed for 14.5% (n = 10) of the total DFU patients and 2.5% of the total patients. Having diabetes-related complications was determined as the strongest predictor of DFU (OR = 7.016, 95% CI = 2.67-18.38), followed by smoking (OR = 3. 80, 95% CI = 2.06-6.99) and age over 64 years (OR = 3.70, 95% CI = 1.299-10.568). Conclusions: The frequency of DFU was high among diabetic patients attending the Diabetes Center of Kerman University of Medical Sciences. Also, hospital admission and foot amputation due to DFU had a considerable frequency. Therefore, there is a crucial need to improve the quality of foot care services and emphasize foot self-care as essential components of diabetes self-management at all levels of the health service delivery system to decrease the risk of DFU.

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“…For example, smoking with diabetes has been linked with the reduced flow of blood in the extremities, peripheral neuropathy, and peripheral arterial problems, which can give rise to foot infections, foot ulcers, and amputation [28]. With diabetic foot infections, smoking has also been associated with delayed healing of wounds [28]. This may be why one of the participants with the longest duration (9 years) of foot ulcer in this study has not yet experienced improvement of their foot ulcer.…”

Section: Discussionmentioning

confidence: 99%

Knowledge, Practice and Attitude towards Foot Ulcers and Foot Care among Adults Living with Diabetes in Tobago: A Qualitative Study

Adeyemi¹,

Olatunji

Adetunji

et al. 2021

IJERPH

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Globally, the prevalence of diabetes has risen significantly by 62% over the last ten years. A complication of unmanaged diabetes is diabetic foot ulcer (DFU), which adversely affects the quality of life of individuals with diabetes and inflicts a huge economic burden on the family, government, and health care services. However, this complication is preventable with adequate patient knowledge and practice regarding DFU and foot care. The present study was aimed at assessing the knowledge, attitude, and practice of adults with diabetes on foot ulcers and foot care in Tobago using a qualitative exploratory design. Purposeful sampling technique was used to recruit 20 participants from the lifestyle and diabetes foot clinics of Scarborough Health Centre, Tobago. Telephone interviews were conducted with the use of a semi-structured interview guide. The data obtained from participants were analyzed using thematic content analysis. Four major themes, namely foot ulcer problems, participants’ knowledge on DFU, knowledge on foot care, and practice and attitude of foot care, emerged from the study. The findings from the study revealed that the majority of participants had poor knowledge regarding DFU but exhibited awareness about foot care, especially on foot cleaning and inspection, preventing irritation after washing, appropriate footwear, and not walking barefooted. The participants had good attitudes and practices of foot care despite their poor knowledge of DFU. However, participants reported inadequate health education on DFU and foot care from healthcare personnel. There should be improved health education, information, and communication on DFU and foot care centred and tailored to the understanding of people living with diabetes. This will prevent DFU and reduce the mortality arising from this complication, which is a major target of the sustainable development goals (SDG) in mitigating the burden of non-communicable diseases (NCD) such as diabetes.

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A study on the impact of smoking and alcoholism as determinant factors in the prognosis and outcome of diabetic foot ulcer disease

Cited by 11 publications

References 10 publications

Clinical and surgical characteristics of infected diabetic foot ulcers in a tertiary hospital of Mexico

Clinical and surgical characteristics of infected diabetic foot ulcers in a tertiary hospital of Mexico

Frequency of Diabetes Foot Ulcer and Related Factors Among Adult Diabetic Patients in the Diabetes Center of Kerman, Iran

Knowledge, Practice and Attitude towards Foot Ulcers and Foot Care among Adults Living with Diabetes in Tobago: A Qualitative Study

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