Endocrine Abstracts

JOINT3876

Introduction: Diabetic foot is a major public health concern, with a high rate of amputations. The complications of diabetic foot disease (DFD) are mainly due to diabetic neuropathy, arteriosclerosis, and infections of ulcers. Offloading of wounds is essential for treating high-risk ulcers. Preventing recurrences relies on patient education, proper foot care, and appropriate offloading.

Objective: To assess the impact of glycemic imbalance on clinical indicators such as delayed wound healing and progression to amputation.

Patients and Methods: A descriptive statistical study was conducted on 276 patients with poor glycemic control (HbA1c > 8%) followed at the diabetic foot consultation in the Endocrinology and Metabolic Diseases Department at Ibn Rochd University Hospital, Casablanca.

Results: The average age was 57 years, with a male predominance of 64.86%. The average duration of diabetes was 14.5 years, and the average HbA1c was 13%. Of the patients, 80.28% were treated with insulin therapy, while 19% were on oral antidiabetic drugs (OAD). The main reason for consultation was diabetic foot ulcers (59.12%) and diabetic ulcer with dermohypodermatitis (40%). The majority of patients had poor footwear as the main trigger factor (68%), followed by post-traumatic causes (11.54%), ischemia (10%), and others. Among the 276 patients with poor glycemic control (HbA1c > 8%), 108 had osteitis. Delayed healing (>15 days) was observed in 247 patients (89%), and 34 of these patients underwent amputation.

Conclusion: It is well established that glycemic imbalance is a factor associated with delayed wound healing. In particular, the benefit of systematic insulin therapy in these patients leads to improved healing outcomes.