Risk categorisation of patients attending a diabetic foot screening clinic in Suez

Abstract

Objective: To identify risk factors and assess diabetic foot ulcer (DFU) and amputation risk category (according to the 2015 International Working Group on the Diabetic Foot (IWGDF) guidance) among patients with type 2 diabetes in the Suez governorate, Egypt. Method: A cross-sectional study was conducted in the diabetic foot screening clinic of Suez General Hospital. A comprehensive sample of patients with type 2 diabetes attending the diabetes clinic every Saturday were enrolled in the study. Patients were divided into four groups according to their history and foot examination: without neuropathy (Group 0); with neuropathy (Group 1); with neuropathy associated with deformity and/or vascular disorders (Group 2); and with foot ulcer or amputation history (Group 3). Results: A total of 220 patients were included in the study. Mean age of participants was 54.6±10.3 years and 70.5% of patients were female. The patients were divided into four groups: 37.3% were in group 0; 37.7% in group 1; 11.8% were in group 2; and 13.2% were in group 3. Male sex and diabetic complications (particularly neuropathy, cardiovascular disease and retinopathy) had the most significant effect on risk classification. Conclusion: This study showed that 62.7% of patients with diabetes enrolled in the study were at risk of developing a DFU and amputation. Physicians should conduct a foot assessment and risk categorisation for all patients with diabetes as early management or referral could prevent further complications.

Diabetic Foot Risk Assessment among Patients with Type 2 Diabetes in Kenya

“…41 However, we report higher numbers of patients with low (36.7%) and moderate (36.1%) risk for diabetic foot were higher than reported in other studies. 37,41,42 For example, the proportion of participants with no risk of developing diabetic foot in our study was much lower than observed in comparative studies in other low-resourced countries e.g., 37.3% in Egypt, 42 57% in Kenyatta National Hospital, 41 and 72.7% in Tunisia. 37 The high proportion of patients with diabetes at high risk of developing diabetic foot in our study may be explained by several local reasons.…”

“…The diabetic foot risk classification has been proposed as an effective tool to prevent lower-extremity complications of diabetes and can form part of a screening system. 42,46 The proportion of participants with previous ulcers in our study was higher than in a recent study in Kenya where only 1.6% and 3.8% of patients had a history of or active foot ulcers, respectively. 8 This was, however, similar to previous studies in sub-Saharan Africa that reported 16% 41 and 4% to 61% 11,12 rates of previous foot ulceration.…”

“…The diabetic foot risk classification has been proposed as an effective tool to prevent lower-extremity complications of diabetes and can form part of a screening system. 42 , 46 …”