Introduction: The screening of patients at diabetic foot risk and the implementation of prevention measures are justified by the frequency and severity of amputations.
The aim of this study was to:
Screen diabetic feet at risk.
List the risk factors associated with the diabetic foot at risk.
Present the methods of management of diabetic foot at risk in our service.
Patients and methods: It was a prospective and observational study, conducted in our department outside patients with recent type 1 diabetes (<5 years), diabetic pregnancies, and patients with non-neuropathy diabetic. Statistical analysis was performed by SPSS software version 19.
Results: We Included 482 patients whose average age was 47.7 years and sex ratio was 1.6. Type 2 diabetes was predominant in 69% of cases, 58% were sedentary, 40% were obese, 42% were hypertensive patients, 48% were dyslipidemic and 12% were smokers. Diabetic nephropathy was present in 36% of cases. According to the IWGDF classification, 24% were at low risk of ulceration, 22% were at moderate risk, 26% were at high risk and 28% at very high risk. The level of risk was significantly correlated (P<0.005) with age, age of diabetes, dyslipidemia, obesity, smoking, physical inactivity and nephropathy. All patients benefited from a therapeutic education. A diabetic foot day was organized every 2nd Wednesday of the month, bringing together an average of 10 to 12 high-grade patients for re-education. Patients with arteriopathy obliterans of the lower limbs were put on treatment and referred for specialist advice. Long-lasting footwear and adapted prostheses are prescribed in consultation with physicians in patients with deformity, corrective surgical management is planned. Over 1 year, among 482 patients, 6 patients with multi-complicated diabetes and grade 3 feet developed a foot injury requiring hospitalization.
Conclusion: The gradation of the podological risk is based exclusively on the clinical examination. Thereafter, patient awareness and education about PD are paramount.
18 - 21 May 2019
European Society of Endocrinology