Predictors of Diabetic Foot Ulcer

Abdul Qadeer Memon, Abdulrahman S Almulhim, Gannam Ali AlGhannam, Saleh A AlMulhim

Abstract

Objective

To study the predictive factors and findings of diabetic foot ulcers.

Study design

Retrospective study.

Place & Duration of study

Department of Surgery, King Fahad Hofuf Hospital Al-Ahsa, Kingdom of Saudi Arabia, from January 2019 to December 2020.

Methodology

The record of the patients admitted for diabetic foot ulcer (DFU) during the above study period was studied and analyzed. The demography, involvement of the areas of foot, complications like neuropathy, nephropathy, retinopathy, peripheral vascular ischemia, HbA1c level and their association with DFU/amputation were studied.

Results

Out of 83 patients having DFU, 43 (51.8%) were males and 40 (48.2%) females. Age was from 18 to 72 years (mean =49.52±8.6 year). The most common age group suffering from diabetes mellitus (DM) was above 40 years of age. Their ankle-brachial systolic pressure index (ABPI) ranged from 0.6 to 1.0 (mean=0.91±0.2). Big toes and the plantar surfaces of forefeet were the common areas affected by DFU. Forty-eight (57.83%) ulcers were infected. Staphylococcus aureus was the most common microorganism. Fifty-four (65%) patients with DFU had amputations. Forty (48.2%) patients were suffering from DM-associated neuropathy, 22 (26.5%) had retinopathy, 9 (10.8%) nephropathy, and 1 (1.2%) cataract. The mean of glycosylated hemoglobin (HbA1c) noted was 8.9±1.28%.

Conclusions

DFU most commonly affects the big toes and planter surface of forefeet. Role of limb ischemia as shown by the ABPI and continuous monitoring and control of DM as shown by the HbA1c play a pivotal role in prevention of DFU. Staphylococcus aureus is the most common infecting microorganism.

Key words

Diabetic foot ulcer, Amputation of foot, Diabetic neuropathy, Nephropathy, Retinopathy, Ankle-brachial index.