Analysis of Severity and Anatomical Distribution of Diabetic Foot Ulcers; A Single Unit Experience

Ambegoda, Madura; Wijesekera, J.; Panditharathne, K I; Gamage, Ranjanie; Mudalige, O M D C S; Piyasiri, M D R M

doi:10.4038/ijms.v2i1.58

Cited by 2 publications

(14 citation statements)

References 22 publications

(17 reference statements)

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“…Results showed that the anatomical distribution of the ulcer among the study participants was found mostly (47.9%) on the right foot and the ulcer located on the plantar of the foot (44.4%, n=117) (p-value =0.009). Our results are at variance with those reported in Korea and Sri Lanka where the commonest location of the ulcer were the toes (56.2%, n=60) and (31.9%, n=91), respectively [21,34].…”

Section: Socio Demographic Characteristicscontrasting

confidence: 99%

“…The majority (44%) of the participants had Grade 3 DFU according to Wagner classi cation, which is in agreement with results of a study in Sri Lanka (40.7%, n=91) [21]. Other studies, however, have reported Grade 2 DFU to be the most common among diabetic patients in Ethiopia (31%) and India (35%) [33][34][35].…”

Section: Socio Demographic Characteristicssupporting

confidence: 86%

“…Ambageda in Sri langa did not nd any statistically signi cant association between any factor with severity of the ulcer, However Stom in Norway found duration of ulcer with the severity with p-value of = 0.042 [21,27,37].…”

Section: Socio Demographic Characteristicsmentioning

confidence: 80%

“…Fasting blood sugar (FBS) and HbA1c were determined using four (4) milliliters (ml) of blood withdrawn from the anterior cubital fossa of each subject using a sterile disposable syringe and needle after cleaning the site with a swab soaked in 70% alcohol. The blood sample was collected in both Ethylene diamine triacetic acid (EDTA) grey top vacutainer for blood sugar tests and glycosylated hemoglobin (HbA1c) [21,27].…”

Section: Study Proceduresmentioning

confidence: 99%

“…Several researches have shown that DFU management outcome is related to patient awareness and self-foot care behavior [18][19][20]. The DFU has been largely studied in developed countries showing that Wagner grades 3 and 4 are the most common and the metatarsal region is the most affected [21][22]. To date, the literature about the anatomical distribution and its relation to the severity of DFU is still lacking in developing countries like Uganda Although DFU and associated factors have been largely studied in developed countries, there is paucity of data about DFU in LMICs like Uganda including factors associated with severity of the diabetic foot ulcer.…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with severity and anatomical distribution of Diabetic Foot Ulcer in Uganda: A multicenter cross-sectional study

Vahwere¹,

Ssebuufu

Namatovu

et al. 2022

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Background: Diabetic foot ulcer (DFU) is a devastating complication of diabetes mellitus (DM) associated with high mortality and morbidity including amputations of lower extremities; and a high economic burden especially in low-income countries like Uganda. The aim of this study was to identify the factors associated with severity of DFU and assess the anatomical distribution of DFU among patients in Uganda. Methodology: This was a multicenter cross-sectional study conducted in 7 selected referral hospitals in Uganda. 117 patients with DM type 1 and 2 and foot ulcers were enrolled for this study from January to March 2021. Using the Wagner classification, patients were categorized as less severe DFU (grade 1 and grade 2) and severe DFU for grade 3 and above. A pre tested questionnaire was used to collect data. Data were analyzed using STATA Version 14 with significance at 95% and p-value of <0.05. Results: Out of 117 patients with DFU, 70 (59.8%) had severe DFU and 47 (40.2%) had less severe DFU. Mean age in years was 57.5 (SD15.2) among all study participants in general. The right foot was affected in (47.9%) of cases and the most frequent ulcer was found on the plantar of the foot (44.4%). Majority of the patients had one ulcer (50.4%) and the most frequent ulcer size was >5 cm (47.9%). Majority (61.5%) of the participants were female. Majority of participants, 90 (76.9%) also had uncontrolled blood sugars and 27(29.1%) had normal glycemia Severity of DFU was 3.4 more prevalent among patients with mild neuropathies (p=0.003), and 2.7 more prevalent for those with moderate neuropathies (p=0.005). Also, severity of DFU was 1.5 more prevalent in patients with an ulcer 5-10 cm of diameter (p=0.047) and 2.5 more prevalent in those with foot ulcer of more than 10 cm of diameter (p=.000). Conclusion:The study showed that most of the DFU patients have severe diabetic foot ulcer and uncontrolled glycemia. Neuropathies and ulcers more than 5cm wide are precipitating factors to severity of DFU and, therefore, early management is important to reduce the burden of the disease.

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Section: Socio Demographic Characteristicscontrasting

confidence: 99%

Section: Socio Demographic Characteristicssupporting

confidence: 86%

Section: Socio Demographic Characteristicsmentioning

confidence: 80%

Section: Study Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors associated with severity and anatomical distribution of Diabetic Foot Ulcer in Uganda: A multicenter cross-sectional study

Vahwere¹,

Ssebuufu

Namatovu

et al. 2022

Preprint

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Factors associated with severity and anatomical distribution of diabetic foot ulcer in Uganda: a multicenter cross-sectional study

et al. 2023

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Background Diabetic foot ulcer (DFU) is a devastating complication of diabetes mellitus (DM) that is associated with increased mortality, morbidity, amputation rate and economic burden. This study aimed at identifying the anatomical distribution and factors associated with severity of DFU in Uganda. Methodology This was a multicenter cross-sectional study conducted in seven selected referral hospitals in Uganda. A total of 117 patients with DFU were enrolled in this study between November 2021 and January 2022. Descriptive analysis and modified Poisson regression analysis were performed at 95% confidence interval; factors with p-value < 0.2 at bivariate analysis were considered for multivariate analysis. Results The right foot was affected in 47.9% (n = 56) of patients, 44.4% (n = 52) had the DFU on the plantar region of the foot and 47.9% (n = 56) had an ulcer of > 5 cm in diameter. The majority (50.4%, n = 59) of patients had one ulcer. 59.8% (n = 69) had severe DFU, 61.5% (n = 72) were female and 76.9% had uncontrolled blood sugar. The mean age in years was 57.5 (standard deviation 15.2 years). Primary (p = 0.011) and secondary (p < 0.001) school educational levels, moderate (p = 0.003) and severe visual loss (p = 0.011), 2 ulcers on one foot (p = 0.011), and eating vegetables regularly were protective against developing severe DFU (p = 0.03). Severity of DFU was 3.4 and 2.7 times more prevalent in patients with mild and moderate neuropathies (p < 0.01), respectively. Also, severity was 1.5 and 2.5 higher in patients with DFU of 5–10 cm (p = 0.047) and in those with > 10 cm diameter (p = 0.002), respectively. Conclusion Most DFU were located on the right foot and on the plantar region of the foot. The anatomical location was not associated with DFU severity. Neuropathies and ulcers of > 5 cm diameter were associated with severe DFU but primary and secondary school education level and eating vegetables were protective. Early management of the precipitating factors is important to reduce the burden of DFU.

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Analysis of Severity and Anatomical Distribution of Diabetic Foot Ulcers; A Single Unit Experience

Abstract: Diabetes is the commonest cause of foot ulceration in developing countries

Cited by 2 publications

References 22 publications

Factors associated with severity and anatomical distribution of Diabetic Foot Ulcer in Uganda: A multicenter cross-sectional study

Factors associated with severity and anatomical distribution of Diabetic Foot Ulcer in Uganda: A multicenter cross-sectional study

Factors associated with severity and anatomical distribution of diabetic foot ulcer in Uganda: a multicenter cross-sectional study

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