Risk assessment of patients with diabetes for foot ulcers according to risk classification consensus of international working group on diabetic foot (IWGDF)

Abstract

Objective: The aim was assessment of diabetic foot ulcer risk factors according to International Working Group on the Diabetic Foot (IWGDF) consensus. Methodology: All referred patients with diabetes were divided into four groups based on IWGDF criteria (without neuropathy, with neuropathy, neuropathy with deformity or vascular disorders, foot ulcer or amputation history). Results: Mean age of patients was 53.8±10.7 years. Two hundred and sixty nine patients ​(62/6%) were female and 161(37/4%) were male. Twenty three percent had disturbed sense of vibration, 26% had decreased sensitivity to monofilaments and 17% had decreased pain sensation. Ankle brachial index (ABI) was abnormal in 6%. About 7% had history of prior ulcer. Patients were classified into four risk groups according to IWGDF criteria. Two hundred and seventy seven patients (65%) were in group 0, 75(17%) in group 1, 47 (11%) in group 2 and 31 (7%) in group 3. Patients in higher–risk groups had higher age, longer diabetes duration, higher HbA1C and less training (p=0.0001, 0.001, 0.0001, 0.021 respectively). The risk was higher in the presence of retinopathy (p=0.005). Patient's sex, BMI, smoking and nephropathy did not have significant correlation with risk of diabetic foot ulcer. Conclusion: This study showed that increase of age, duration of diabetes and HbA1c, lack of training and presence of retinopathy increases the risk of diabetic foot ulcers.

Prediction of diabetic foot ulcer healing in type 2 diabetic subjects using routine clinical and laboratory parameters

“…A validated relationship has also been established between HbA1c levels and various pathological complications in diabetic patients such as diabetic retinopathy and foot ulcers. 18,19 However, there are conflicting data published regarding HbA1c levels as a determinant of ulcer healing process. A prospective study involving 314 diabetic patients with foot ulcers showed a significant association between various clinical risk factors and the healing process but with little evidence of association with short-term metabolic control assessed by HbA1c analysis.…”

Asociação entre internação hospitalar por diabetes mellitus e amputação de pé diabético

“…El estudio de datos epidemiológicos subsidia la formulación de políticas de salud regionales, pues evidencia la tasa de comprometimiento neurológico y vascular en pies de pacientes con diabetes, además de guiar intervenciones de cuño preventivo (9) . Así, la detección precoz es una forma de reducir la gravedad de las complicaciones incluyendo amputaciones evitables (7,10) .…”

Foot Care Knowledge and Practice among Diabetic Patients Attending General Outpatient Clinic in Tribhuvan University Teaching Hospital

“…This non-communicable disease is a global public health threat that has increased dramatically over the past two decades [3] [4]. The global prevalence of diabetes has nearly doubled since 1980, rising 4.7% to 8.5% in the adult population [5].…”