Characteristics and Outcomes of Subjects With Diabetic Foot Ulceration

Riaz, Musarrat; Miyan, Zahid; Zaidi, Shabih H.; Alvi, Syed Faraz Danish; Fawwad, Asher; Ahmadani, Muhammad Yakoob; Zafar, Asim Bin; Malik, Rayaz A.; Basit, Abdul

doi:10.2337/dc11-1906

Cited by 10 publications

(9 citation statements)

References 3 publications

(3 reference statements)

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“…This study provides a large analysis of patients with diabetes comparing those at low risk with high risk for foot ulceration in relation to risk factors and also defines the outcomes of patients with foot ulceration at a tertiary care diabetes centre in Karachi, Pakistan. It builds on our recent data assessing outcomes in a smaller cohort of patients .…”

Section: Discussionmentioning

confidence: 99%

Characteristics of a large cohort of patients with diabetes having at‐risk feet and outcomes in patients with foot ulceration referred to a tertiary care diabetes unit

Riaz

Miyan

Zaidi

et al. 2014

International Wound Journal

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To identify in a large population cohort the clinical and biochemical characteristics of patients with diabetes at risk of foot ulceration and outcomes in those with foot ulcers. All patients with diabetes attending Baqai Institute of Diabetology and Endocrinology from January 2004 to April 2012 included in the study. Clinical, biochemical and socio-demographic data were collected and patients were categorised into those at no risk of ulceration, at risk of ulceration and those with foot ulcer, according to the University of Texas classification. Patients with foot ulceration followed for their final outcome, that is complete healing, persisted non-healed ulcer, lower extremity amputation, lost to follow-up or death. A total of 18 119 patients with diabetes underwent assessment, 3576 (19·7%) patients defined as at high risk for foot ulceration and 3731 (20·6%) presented with foot ulcer. Age, male gender, hypertension, higher glycated haemoglobin (HbA1c), history of smoking and presence of neuropathy were risk factors (P < 0·000) for foot ulceration. Amputation rate in patients with foot ulceration was significantly related to severity of ulceration at presentation. Preventive foot care practices were followed by 19·02% patients. One thousand eight hundred seventy three (50·2%) patients completely healed, 293 (11%) patients underwent amputation and 397 (10·1%) patients continued to be treated in the foot clinic. All patients with diabetes should be screened for neuropathy to identify those at risk of foot ulceration, as it is the major contributory factor for foot ulceration. The final outcome of foot ulceration was determined by the severity and grade of ulcer at presentation.

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Section: Discussionmentioning

confidence: 99%

Characteristics of a large cohort of patients with diabetes having at‐risk feet and outcomes in patients with foot ulceration referred to a tertiary care diabetes unit

Riaz

Miyan

Zaidi

et al. 2014

International Wound Journal

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“…Among the complications, diabetic ulcer disease has gained importance because of the socioeconomic burden it imposes on the patient, the patient’s family and on the health care system of the country. In UK and USA the prevalence of foot ulceration due to diabetes has found to be 5-7% [2]) and 6% [3] respectively, whereas in the developing countries it has shown a higher percentage [4,5]. In Sri Lanka, one third of type 2 diabetes patients have a risk of foot ulceration with some progressing to limb amputations [6].…”

Section: Introductionmentioning

confidence: 99%

Predictors of Diabetic Foot and Leg Ulcers in a Developing Country with a Rapid Increase in the Prevalence of Diabetes Mellitus

et al. 2013

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ObjectiveTo identify the socio demographic, life style and foot examination related predictors of diabetic foot and leg ulcers with a view to develop a screening tool appropriate for the use in an outpatient setting.Research design and methodsThis cross sectional study included type 2 diabetes mellitus (DM) patients; 88 subjects with leg and foot ulcers and 80 non ulcer controls. Socio demographic data and life style factors were documented. Foot was examined for skin changes and structural abnormalities. Distal peripheral neuropathy was assessed by pressure sense, vibration sense and joint position sense. Multivariate analysis by logistic regression was used to determine the significant predictors in screening for foot ulcers.ResultsEducation of grade 6 and below (OR - 1.41, 95% CI; 1.03 - 4.68), low income (OR - 23.3, 95% CI; 1.5 - 34.0), impaired vibration sense (OR - 24.79, 95% CI; 9.3 - 66.2), abnormal monofilament test on first (OR - 1.69, 95% CI; 1.36 - 16.6), third (OR - 3.4, 95% CI; 1.1 - 10.6) and fifth (OR - 1.8, 95% CI; 1.61- 12.6) toes are found to be predictors of increased risk whereas incidental diagnosis of DM (OR - 0.03, 95% CI; 0.003 - 0.28), wearing covered shoes (OR - 0.003, 95% CI; 0.00 - 0.28), presence of normal skin color (OR - 0.01, 95% CI; 0.001 - 0.14) and normal monofilament test on first metatarsal head (OR - 0.10, 95% CI; 0.00 - 0.67) are protective factors for ulcers.ConclusionsTen independent risk and protective factors identified in this study are proposed as a simple screening tool to predict the risk of developing leg and foot ulcers in patients with DM.

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“…At least 40% of amputations in diabetic patients can be prevented with a team approach to wound care (15). The incidence of diabetic foot ulceration is higher in developing countries like Pakistan because of various sociocultural factors (16). In this study, we evaluated the risk factors related to poor outcome in diabetic patients with foot ulcers.…”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with poor outcome in diabetic foot ulcer patients

Saleem¹,

Hayat²,

Ahmed³

et al. 2017

Turk J Med Sci

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Background/aim: Diabetic foot ulcers and related complications are a major cause of morbidity and hospital admissions. Our aim was to evaluate the risk factors associated with poor outcome in diabetic foot ulcers. Materials and methods:A prospective study was conducted on patients with diabetic foot ulceration attending the Madinah Teaching Hospital from June 2014 to December 2015. Potential risk factors and laboratory test results at presentation were recorded and their association with outcome (healing vs. amputation) was analyzed using IBM SPSS Statistics for Windows, Version 22.0.Results: In total, 112 patients were studied during our study period. The majority of the patients were male (60.7%) and aged 50 years and older (62.5%). Regarding the outcome, 68% healed completely, 27.7% underwent amputation, and 4.5% died during this period. Patient age of 50 and older, long duration of diabetes (>10 years), rural origin, and heel ulcers were significantly associated with poor outcome (P < 0.05). Conclusion:Patients with diabetes should have a detailed annual foot examination; those having risk factors for poor outcome require more frequent foot care, patient education, and early referral to tertiary care centers.

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Characteristics and Outcomes of Subjects With Diabetic Foot Ulceration

Cited by 10 publications

References 3 publications

Characteristics of a large cohort of patients with diabetes having at‐risk feet and outcomes in patients with foot ulceration referred to a tertiary care diabetes unit

Characteristics of a large cohort of patients with diabetes having at‐risk feet and outcomes in patients with foot ulceration referred to a tertiary care diabetes unit

Predictors of Diabetic Foot and Leg Ulcers in a Developing Country with a Rapid Increase in the Prevalence of Diabetes Mellitus

Risk factors associated with poor outcome in diabetic foot ulcer patients

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