Diabetes mellitus and non-traumatic lower extremity amputations in four public sector hospitals in Cape Town, South Africa, during 2009 and 2010

G, Dunbar; Hellenberg, Derek; Levitt, Naomi

doi:10.7196/samj.2015.v105i12.9276

Cited by 25 publications

(30 citation statements)

References 21 publications

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“…52 Regular screening of T2DM patients for sensory and vascular foot changes and patient education programmes on DFD including advice on preventative actions, should be highlighted and reinforced in health institutions. 11,44,48,51,53,54 Daily foot inspection by patients can prevent DFD and its fatal complications. The importance of good knowledge and practice should be stressed and reinforced in T2DM patients who have established peripheral neuropathy so as to reduce the number of diabetic amputations and improve survival.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 DFD accounts for 20% of all hospitalisations of T2DM patients in sub-Saharan Africa, and frequently leads to chronic disabilities, loss of income, lower limb amputation or death. 7,9,10,11 It is estimated that one in every five persons with DM (type 1 and type 2) has a 15% probability of developing a foot infection in a year, and 5% of DM patients with DFD will eventually undergo amputation. 12,13,14 Despite various interventions, DFD remains a common and significant clinical problem affecting quality of life and quality of care that disrupts patients’ psychosocial and physical state and has a negative impact on their overall perception of the disease.…”

Section: Introductionmentioning

confidence: 99%

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Awareness of diabetic foot disease amongst patients with type 2 diabetes mellitus attending the chronic outpatients department at a regional hospital in Durban, South Africa

Goie

Naidoo

2016

Afr. j. prim. health care fam. med.

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BackgroundDiabetic foot disease (DFD) is a major challenge for the healthcare system, with enormous economic consequences for people living with diabetes, their families, and society, affecting both quality of life and quality of care. The study aim was to assess the level of awareness of DFD amongst patients with type 2 diabetes mellitus (T2DM).MethodsAn observational descriptive cross-sectional study was conducted at the chronic outpatients department of a regional hospital in Durban, South Africa.ResultsTwo hundred participants with T2DM participated in the study. Ninety-one per cent of participants were either overweight or obese. Ninety-two per cent of participants had concomitant hypertension (57.5%), dyslipidaemia (26.7%) and eye disease (7.2%). Seventy-six per cent reported altered sensation in their lower limbs, and 90% reported having no previous DFD education. Only 22.2% of participants reported having examined their feet, but only when they experienced a problem. Participants achieved mediocre scores for knowledge (mean 4.45, standard deviation (s.d.) 2.201, confidence interval (CI) 4.2–4.7) and practice (mean 11.09, s.d. 2.233, CI 10.8–11.5) on diabetic foot care (DFC). Those who had a higher level of education and who were less than 65 years old had a significantly better score for previous foot care education (p <0.05).ConclusionThe study demonstrated that awareness of DFD was suboptimal, based on current DFC guidelines. To minimise the burden of DFD, improved screening and prevention programmes as well as patient education should be provided to T2DM patients, whilst maintaining an aggressive approach to risk factor modifications, footwear and identifying the at-risk foot.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Awareness of diabetic foot disease amongst patients with type 2 diabetes mellitus attending the chronic outpatients department at a regional hospital in Durban, South Africa

Goie

Naidoo

2016

Afr. j. prim. health care fam. med.

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“…In high income countries (HICs), peripheral vascular disease ranked first as the cause of amputation while trauma, infection, complications of diabetes mellitus and malignancy are indications for amputation in low-to middle-income countries (LMICs). 3,4 In a study conducted in four public hospitals in Cape town, 72.3% of LEAs were in people with diabetes mellitus. 3 Patients undergoing LEA have considerable risk factors for chronic medical conditions such as hypertension (77%), hypercholesterolemia (29%), raised serum creatinine (35%) and/or history of smoking (82%).…”

Section: Introductionmentioning

confidence: 99%

“…3,4 In a study conducted in four public hospitals in Cape town, 72.3% of LEAs were in people with diabetes mellitus. 3 Patients undergoing LEA have considerable risk factors for chronic medical conditions such as hypertension (77%), hypercholesterolemia (29%), raised serum creatinine (35%) and/or history of smoking (82%). 5 Hypertension is a major risk factor for lower extremity amputation if untreated.…”

Section: Introductionmentioning

confidence: 99%

Knowledge and attitude of patients undergoing lower extremity amputation at RK Khan Hospital, Chatsworth

Olotu¹,

Anderson²

2019

S. Afr. j. surg.

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Background: Amputation is one of the oldest and most commonly performed surgical procedures. Objective: To review the knowledge and attitude of patients undergoing lower extremity amputations and describe the associated causative factors. Methodology: A questionnaire-based prospective study assessing patients either preoperatively or immediately postoperatively regarding their knowledge and attitudes toward lower extremity amputation was conducted between November 2016 and April 2017. Extracted data was captured into an Excel spreadsheet and imported into SPSS for statistical analysis. Results: Sixty-three amputations were performed with males accounting for 56% of the study population. The majority were in the age group of 61-70 years (33%). The commonest indication for amputation was complication of diabetes mellitus or diabetes foot sepsis (65%). Below-knee amputation (BKA) was the most frequently performed procedure and accounted for 56% of all amputations. Seventy per cent of the participants had formal education and 60% knew that their condition could lead to an amputation, but only approximately 10% visited the foot clinic before their major amputation despite the service being available at RK Khan Hospital. Smoking was the commonest habit associated with amputation. Conclusion: Complications of diabetic mellitus are the most common indication for lower extremity amputation. A high percentage of patients knew their co-morbid condition could lead to limb loss but failed to seek medical assistance until late in their disease process.

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“…Diabetic foot disease accounts for 20% of all hospitalizations of type 2 diabetes patients in sub-Saharan Africa, and frequently leads to chronic disabilities, loss of income, lower limb amputation and death. [2][3][4] [5]. It accounts for more hospital admissions than any other complication of diabetes, and contribute substantially for health care costs.…”

Section: Introductionmentioning

confidence: 99%

Knowledge, Attitude, and Practice of Foot Care among Type 2 Diabetic Patients Attending Diabetic Clinic. Al Ribat Teaching Hospital in Sudanese Patients

Mohammed¹,

Rahman²

2018

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Diabetic foot complications are a major challenge for the healthcare system, with enormous economic consequences for the patients, their families, and the society and a leading cause of mortality and morbidity in developing countries. Diabetic foot ulcer (DFU) is the most costly and devastating complication, which affects 15% of diabetic patients during their lifetime. Good knowledge, attitude, and practice regarding diabetic foot care will reduce the risk of diabetic foot complications and ultimately amputations. The aim of this study was to assess the knowledge, attitude, and practice of foot care among type 2 diabetic patients and to determine the relationship between proper foot care and diabetic foot lesions. This is an observational, descriptive, cross-sectional, hospitalbased study. It was conducted in the diabetic outpatient clinic at Al-Ribat University Hospital, in Khartoum, Sudan 2016. A total number of 156 type 2 diabetic patients were enrolled in this study; with 75% of the participants were females and 25% males. Duration of DM, exercise, smoking adherent to diabetic diet, type of therapy, co-morbidity, foot lesions, and foot care knowledge, attitude, and practice were tested. Having diabetes longer than 10 years were 37.8%, mean age was 53.4 ± 7.68 years. There was high prevalence of peripheral neuropathy(PN) symptoms 56.4% while 42.3% of the patients had peripheral arterial disease symptoms .17 patients had loss of sensation while only 2 patients had loss of peripheral pulses (dorsalis pedis and posterior artery pulses). Regarding knowledge, attitude, and practice about diabetic foot care, 56.5% had good foot care knowledge, 70.5% had bad attitude, and 62.2% had moderate practice. Based on Chi square test of relationship between proper foot care and diabetic foot ulcer (DFU), there was association between bad knowledge, attitude, and practice about foot care and DFU, P. values: 0,03, 0,000, 0.036 respectively. Advising the diabetics about frequent foot care clinic visits, regular feet examination, proper footwear, exercise program, and smoking cessation would be beneficial in preventing diabetic foot complication. Policy and decision makers should initiate interventional foot care education programs throughout the country, with our ultimate goal is to save limbs.

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Diabetes mellitus and non-traumatic lower extremity amputations in four public sector hospitals in Cape Town, South Africa, during 2009 and 2010

Cited by 25 publications

References 21 publications

Awareness of diabetic foot disease amongst patients with type 2 diabetes mellitus attending the chronic outpatients department at a regional hospital in Durban, South Africa

Awareness of diabetic foot disease amongst patients with type 2 diabetes mellitus attending the chronic outpatients department at a regional hospital in Durban, South Africa

Knowledge and attitude of patients undergoing lower extremity amputation at RK Khan Hospital, Chatsworth

Knowledge, Attitude, and Practice of Foot Care among Type 2 Diabetic Patients Attending Diabetic Clinic. Al Ribat Teaching Hospital in Sudanese Patients

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