scholarly journals Predictive value of the risk factors for amputation of lower extremity in patients with diabetic foot in Al-Karama teaching hospital

2019 ◽  
Vol 6 (5) ◽  
pp. 1549
Author(s):  
Mohammed Hillu Surriah ◽  
Amir Naif Kadum Al-Imari ◽  
Amine Mohammed Bakkour ◽  
Riad Rahman Jallod Al-Asadi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Teaching Hospital ◽  
Diabetic Foot ◽  
Significant Risk ◽  
Female Ratio ◽  
Duration Of Diabetes ◽  
Long Duration ◽  
Control Of Diabetes ◽  
Foot Disease

Background: Diabetic foot disease is a foot that exhibits any pathology that results directly from diabetic mellitus or any long-term chronic complication of diabetes mellitus. The aim of the study was to determine the risk factors and indications for amputations among diabetics.Methods: this clinical prospective study includes 120 diabetic foot patients admitted to AL- Karama teaching hospital from 1st January 2015 to 1st January 2019. All patients assessed for age, gender, duration of diabetes, hyperglycemia at admission and control of diabetes, history of smoking, hypertension, assess dominant foot and examination of diabetic foot lesion and classify it according to Meggit-Wagner grading status, indications for amputation and outcome.Results: The male to female ratio was 2:1. Most frequent age group of patients treated by amputation was between 50-80 years. Among patients treated with amputation (68.33%) of patients had diabetes mellitus for 11-20 years. From patients admitted with diabetic foot (53.33%) were smokers. Regarding hypertension (93.33%) of all patients were hypertensive. It was noted that (65%) of patients lesion occur in dominant foot Regarding Wagner's grading system (36.66%) of patients were grade 4 followed by grade 1 (21.66%). regarding mode of treatment (53.33%) of patients treated by amputation and other treated conservatively. Only 3 patients from 60 died while other discharged well after complete treatment.Conclusions: Increasing in age, long duration of diabetes mellitus, poor control of diabetes, smoking and occurrence of lesion in dominant foot all considered as a significant risk factors for increase liability amputation.

scholarly journals Prevalence of chronic kidney disease stages 3-5 among patients with type 2 diabetes mellitus in Bangladesh

2017 ◽  
Vol 11 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Muhammad Abdur Rahim ◽  
Palash Mitra ◽  
Hasna Fahmima Haque ◽  
Tasrina Shamnaz Samdani ◽  
Shahana Zaman ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Significant Risk ◽  
Duration Of Diabetes

Background and objectives: Diabetes mellitus is one of the most common causes of chronic kidney disease (CKD). The prevalence of CKD in type 2 diabetes mellitus (T2DM) in Bangladesh is not well described. The present study aimed to find out the prevalence of CKD stages 3-5 and its risk factors among selected Bangladeshi T2DM patients.Methods: This cross-sectional study was conducted in BIRDEM (Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders) General Hospital, Dhaka, Bangladesh from July to December 2015. Diagnosed adult T2DM patients were consecutively and purposively included in this study. Pregnant women, patients with diagnosed kidney disease due to non-diabetic etiology, acute kidney injury (AKI), AKI on CKD and patients on renal replacement therapy were excluded. Age, gender, body mass index (BMI) and laboratory parameters were recorded systematically in a predesigned data sheet. Diagnosis of CKD and its stages were determined according to Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guidelines 2012 and estimated glomerular filtration rate (eGFR). Estimated GFR was calculated by using Modification of Diet in Renal Disease (MDRD), Cockcroft-Gault (CG) and Chronic Kidney Disease Epidemiology (CKDEPI) creatinine based formula.Results: A total of 400 patients with T2DM of various durations were enrolled in the study. Out of 400 patients, 254 (63.5%), 259 (64.75%) and 218 (54.5%) cases had CKD stages 3-5 according to MDRD, C-G and CKD-EPI equations respectively. CKD was significantly more common in females (p<0.001) and in cases with long duration of diabetes (?5 years; p=0.007). CKD stages 3-5 were significantly associated with hypertension (?2=5.2125, p =0.02) and good control of diabetes (HbA1c <7%) as evidenced by higher proportion of CKD in them (73.3%) compared to those with poor glycemic control (52.1%).Conclusions: More than half of T2DM patients had CKD stages 3-5. Female gender, duration of diabetes and hypertension were significant risk factors and should be emphasized for the prevention of CKD in T2DM. Glycemic control may not reduce CKD in diabetes.IMC J Med Sci 2017; 11(1): 19-24

scholarly journals Profile, Bacteriology, and Risk Factors for Foot Ulcers among Diabetics in a Tertiary Hospital in Calabar, Nigeria

Ulcers ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Akaninyene Asuquo Otu ◽  
Victor Aniedi Umoh ◽  
Okon Ekwere Essien ◽  
Ofem Egbe Enang ◽  
Henry Ohem Okpa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Diabetic Foot ◽  
Average Duration ◽  
Current Trend ◽  
Sensory Neuropathy ◽  
Economic Problem ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Foot Disease

Diabetic foot disease is a major medical, social, and economic problem. This retrospective study assessed the profile of diabetes mellitus patients with foot ulcers in the University of Calabar Teaching Hospital (UCTH), Nigeria. Admission records of all patients admitted unto the medical wards of UCTH over a 5 year period were analysed. The records of diabetic patients were retrieved. Data on patient characteristics and possible risk factors for diabetes mellitus foot ulcers was extracted. Of the 3,882 patients admitted, 297 (7%) were on account of complications of diabetes mellitus. Foot ulcers accounted for 63 (21.2%) of all diabetic admissions. The elderly constituted the majority of patients admitted with foot ulcers. The average duration of stay of diabetics with foot ulcers was 38.5 days. Diabetics admitted for other conditions had average duration of admission of 15.8 days. Staphylococcus aureus was the commonest organism isolated from swabs of foot ulcers. Most of the organisms identified from ulcer swab cultures were sensitive to quinolones and resistant to penicillins. These diabetic foot ulcers were significantly associated with peripheral sensory neuropathy, peripheral vascular disease, intermittent claudication, and walking barefoot. An effective diabetes foot programme is required to address these risk factors and reverse the current trend.

scholarly journals A Retrospective Study Assessing the Risk Factors of Type 2 Diabetes Mellitus Linked to Diabetic Foot Ulcer Incidence in Jiaxing, China

2021 ◽  
Author(s):  
Qiang Zhou ◽  
Minjie Mao ◽  
Yichuan Shao ◽  
Danlu Yu ◽  
Shengjie Tang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Diabetic Foot ◽  
Protective Factor ◽  
Course Of Disease ◽  
Diabetic Foot Disease ◽  
Independent Risk Factors ◽  
Foot Disease

Abstract Objective: Diabetic foot (DF) is one of the common serious complications of diabetes, which is an important cause of death and disability, and is associated with diabetic vascular disease and diabetic neuropathy. The purpose of this study was to assess the incidence and risk factors for diabetic foot among a diabetic population. Methods: The study was a retrospective cohort review. The population studied was 348 male examinees of type 2 diabetes mellitus (DM), in which age-matched equal examinees (174 patients each) were with diabetic foot (DF Group) and with no indication of diabetic foot (non-DF group), hospitalized in the same year at The First Hospital of Jiaxing, China. Medical records were reviewed to collect clinical profile, including duration of disease, smoking, previous diabetic foot incidence, and medication (such as metformin). Categorical data between groups were analyzed using chi-square test (χ2). Unconditional logistic regression analysis was used for multi-factor analysis to identify the risk factors of diabetic foot. Results: Comparing the baseline data of DF Group and non-DF Group, age, course of disease, LDL-C and use of metformin showed no significant difference (P >0.05). The results of the logistic regression analysis showed that smoking history (OR=1.88, P=0.020), previous diabetic foot history (OR=2.290, P=0.016), Hcy (OR=1.194, p≤0.001) were independent risk factors for diabetic foot disease, and HgB (OR =0.984, P=0.021) was the protective factor of diabetic foot disease in male subjects. Age (OR=0.985, P=0.304), course of disease (OR=1.048, P=0.233), history of metformin use (OR=0.851, P=0.509), HbA1c (OR=1.302, P=0.059), LDL-C (OR=0.936, P=0.698), Creatinine (OR =1.010, P=0.326), and ALB (OR =0.943, P=0.084) were not significantly correlated with diabetic foot disease. Conclusions: Smoking, previous diabetic foot history, and homocysteine are independent risk factors for diabetic foot disease. HgB is the protective factor of diabetic foot disease in male patients.

scholarly journals A Study of the Risk Factors Predicting Amputation in Diabetic Foot

2021 ◽  
Vol 6 (3) ◽  
pp. 21-25
Author(s):  
Amara Simha Reddy. T ◽  
Prashant G.K.
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Medical Science ◽  
Significant Risk ◽  
Arterial Disease ◽  
Major Amputation ◽  
Foot Ulcers ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Peripheral Arterial

Background: Diabetic foot ulcers are the main cause of non-traumatic lower extremity amputation. The objective of this study was to evaluate the risk factors for major amputation in diabetic foot patients. Materials & Methods: This open, single center, prospective and observational study conducted in Chalmeda Anand Rao Institute of Medical Science, Karimnagar for a period from Nov. 2018 to Dec. 2020 The patients admitted in General Surgery with diabetic foot problems were selected for the study with proper consent of patients and his/her attendants. Results: In this study Fifty patients were admitted to the diabetic wound in Department of Surgery for foot ulcers between Nov 2018 to Dec 2020. Among the 50 patients, Male: Female ratio was 4.6:1. out of which 41 (82.0%) were male, 18 (36.0%) belonged to the 50 to 59 years age group, 15 (30.0%) were having complaints for Ulcer, 15 (30.0%) were smoker. The Amputation rate was 42.0%. Conclusion: In the results of analysis, poor glycemic control, peripheral arterial disease, peripheral neuropathy and higher Wagner grade are significant risk factors for amputation in diabetic foot infection. Keywords: Diabetic foot, Wagner grading, HbA1c, TLC, Albumin.

scholarly journals Diabetic Foot Disease—Incidence and Risk Factors: A Clinical Study

2016 ◽  
Vol 3 (1) ◽  
pp. 41-46
Author(s):  
Rajesh Kapila ◽  
Rakesh Sharma ◽  
Ashwani K Sharma ◽  
Jagsir Mann
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Diabetic Foot ◽  
Disease Incidence ◽  
Diabetic Patients ◽  
Elderly Males ◽  
Diabetic Foot Disease ◽  
Foot Disease

ABSTRACT Diabetic foot disease is one of the most common, yet dreaded long-term complication of diabetes mellitus, especially in developing countries. It is the single-most common cause of nontraumatic lower limb amputations. Various studies worldwide have shown an incidence of diabetic foot to be 15 to 25%. Elderly males who are smokers and have habit of alcohol intake and have long duration of type 2 diabetes are at major risk for this problem. The other significant risk factors are: Poor glycemic control, neuropathy, angiopathy, nephropathy, and retinopathy. Management of diabetic foot disease involves a multidisciplinary approach. The present study was conducted with the aim to know about the prevalence of the incidence of diabetic foot disease in diabetic patients and to enumerate the different risk factors associated with it for the occurrence of diabetic foot disease in such patients at the time of presentation. Over a period of 1 year, a prospective study involving 1,016 diabetic patients as per World Health Organization (WHO) criteria were screened for diabetic foot disease. All cases were graded as per University of Texas classification. Incidence of diabetic foot disease was calculated and the risk factors were identified through proper history taking, clinical evaluation, and specialized tests as and when required. Some of the common risk factors identified in our study were: Elderly males from poor families having long-term type 2 diabetes and who were smokers and alcoholics. Many of these patients had other systemic complications of diabetes in the form of neuropathy, retinopathy, angiopathy, and nephropathy as well. A very important, yet easily modifiable risk factor was poor glycemic control. Our conclusion from the study is being that the diabetic foot disease is much common than anticipated in diabetes mellitus patients; it is on the rise and the resultant morbidity is very crippling to the affected individuals. Therefore it is very important to identify the risk factors and educate patients about them, especially the modifiable risk factors, so that its incidence and the morbidity can be brought down significantly. How to cite this article Sharma R, Kapila R, Sharma AK, Mann J. Diabetic Foot Disease—Incidence and Risk Factors: A Clinical Study. J Foot Ankle Surg (Asia-Pacific) 2016;3(1):41-46.

Renal Failure after Coronary Bypass Surgery and the Associated Risk Factors

2015 ◽  
Vol 18 (1) ◽  
pp. 006
Author(s):  
Hasan Reyhanoglu ◽  
Kaan Ozcan ◽  
Murat Erturk ◽  
Fatih İslamoglu ◽  
İsa Durmaz
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Renal Failure ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Significant Risk ◽  
High Morbidity ◽  
Factors Associated

<strong>Objective:</strong> We aimed to evaluate the risk factors associated with acute renal failure in patients who underwent coronary artery bypass surgery.<br /><strong>Methods:</strong> One hundred and six patients who developed renal failure after coronary artery bypass grafting (CABG) constituted the study group (RF group), while 110 patients who did not develop renal failure served as a control group <br />(C group). In addition, the RF group was divided into two subgroups: patients that were treated with conservative methods without the need for hemodialysis (NH group) and patients that required hemodialysis (HR group). Risk factors associated with renal failure were investigated.<br /><strong>Results:</strong> Among the 106 patients that developed renal failure (RF), 80 patients were treated with conservative methods without any need for hemodialysis (NH group); while <br />26 patients required hemodialysis in the postoperative period (HR group). The multivariate analysis showed that diabetes mellitus and the postoperative use of positive inotropes and adrenaline were significant risk factors associated with development of renal failure. In addition, carotid stenosis and postoperative use of adrenaline were found to be significant risk factors associated with hemodialysis-dependent renal failure (P &lt; .05). The mortality in the RF group was determined as 13.2%, while the mortality rate in patients who did not require hemodialysis and those who required hemodialysis was 6.2% and 34%, respectively.<br /><strong>Conclusion:</strong> Renal failure requiring hemodialysis after CABG often results in high morbidity and mortality. Factors affecting microcirculation and atherosclerosis, like diabetes mellitus, carotid artery stenosis, and postoperative vasopressor use remain the major risk factors for the development of renal failure.<br /><br />

Current Concepts in Diabetic Microvascular Dysfunction

2006 ◽  
Vol 96 (3) ◽  
pp. 245-252 ◽  
Author(s):  
Javier La Fontaine ◽  
Lawrence B. Harkless ◽  
Christian E. Davis ◽  
Marque A. Allen ◽  
Paula K. Shireman
Keyword(s):  
Diabetic Foot ◽  
Vascular System ◽  
Microvascular Dysfunction ◽  
Diabetic Macroangiopathy ◽  
Patients With Diabetes ◽  
Foot Problems ◽  
Control Of Diabetes ◽  
Diabetic Foot Disease ◽  
Foot Disease ◽  
Pathologic Processes

Microvascular dysfunction is an important component of the pathologic processes that occur in diabetic foot disease. The endothelial abnormalities observed in patients with diabetes mellitus are poorly understood, and evidence suggests that endothelial dysfunction could be involved in the pathogenesis of diabetic macroangiopathy and microangiopathy. With the advent of insulin replacement in the early 1900s and increased efforts toward metabolic control of diabetes, long-term complications of this disease have become apparent. These late-term complications are primarily disorders of the vascular system. This article reviews the process of microvascular dysfunction and how it may relate to the pathogenesis of diabetic foot problems. (J Am Podiatr Med Assoc 96(3): 245–252, 2006)

Association Between the Diabetes mellitus Duration and the Severity of Diabetic Foot Disease in Hospitalized Patients in Latin America

2021 ◽  
pp. 153473462110632
Author(s):  
Belissa Bedriñana-Marañón ◽  
Maria Rubio-Rodríguez ◽  
Marlon Yovera-Aldana ◽  
Eilhart Garcia-Villasante ◽  
Isabel Pinedo-Torres
Keyword(s):  
Diabetes Mellitus ◽  
Latin America ◽  
Diabetic Foot ◽  
Poisson Regression ◽  
Hospitalized Patients ◽  
Bivariate Analysis ◽  
Severe Injuries ◽  
History Of ◽  
Diabetic Foot Disease ◽  
Foot Disease

The objective was to determine the association between a diabetes mellitus duration greater than 10 years and the severity of diabetic foot in hospitalized patients in Latin America. Analytical, observational, and retrospective study based in secondary databases. Patients older than 18 years with diagnosis of diabetes mellitus (DM) and hospitalized for any causes were included. The independent and dependent variables were having more than 10 years of diagnosis of DM and the severity of the diabetic foot disease (Wagner> = 2), respectively. A crude Poisson regression analysis was performed to obtain prevalence rates adjusted to confounders. Male gender was 54.8% and the median age was 62 years. In the group with more than10 years of disease (n = 903) 18% (n = 162) had severe injuries. We performed two Poisson regression analyzes, one of which included the entire sample; and in the other, only patients with some degree of ulcer were included at the time of evaluation (Wagner > = 1). In the first analysis the PR was 1.95 ( p < 0.01) adjusted for the significant variables in the bivariate analysis and in the second analysis the PR was 1.18 ( p < 0.01) adding to the adjustment the days of injury prior to hospitalization and the location of the ulcer. We conclude that in patients with more than 10 years of diabetes mellitus, diabetic foot injuries are more severe, regardless type of diabetes, gender, age, history of amputation and days of injury prior to hospitalization for inpatients in Latin America.

Features of the course of coronavirus infection in patients with diabetes mellitus

2022 ◽  
pp. 18-21
Author(s):  
Vladimir Anatolievich Klimov ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Human Population ◽  
Fatal Outcome ◽  
Significant Risk ◽  
Adverse Outcomes ◽  
Concomitant Disease ◽  
Patients With Diabetes ◽  
Coronavirus Infection ◽  
Population Mortality

Diabetesmellitus, overweight and the age of a patient over 65 years old are identified by clinicians as themain factors that can complicate the course of the coronavirus infection and increase the likelihood of fatal outcome. Although in the general human population mortality from coronavirus fluctuateswithin 3–5 %, sometimes very significantly differing in individual countries, this level can reach 15–25 % among patientswith diabetes, especially for those receiving insulin therapy. Diabetes mellitus as a concomitant disease in COVID-19 is considered one of the most significant risk factors for the development of adverse outcomes due to a more severe course of infection in conditions of hyperglycemia and other aggravating factors.

Clinical factors and mortality rates for non-traumatic upper extremity amputations

2021 ◽  
pp. 175319342110427
Author(s):  
Yong-Zheng Jonathan Ting ◽  
An-Sen Tan ◽  
Chi-Peng Timothy Lai ◽  
Mala Satku
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Lower Extremity ◽  
Upper Extremity ◽  
Significant Risk ◽  
Arterial Disease ◽  
Mortality Rates ◽  
Level Of Evidence ◽  
Peripheral Arterial ◽  
Extremity Amputation

Non-traumatic upper extremity amputations are an increasing concern with the rising prevalence of diabetes mellitus. To ascertain the risk factors and mortality rates for these amputations, the demographic information, amputation history, comorbidities and clinical outcomes of 140 patients who underwent non-traumatic upper extremity amputations between 1 January 2004 and 31 October 2017 were studied. Correlations were assessed using Cochran-Armitage chi-squared tests, odds ratios and multivariate binomial logistic regression as appropriate. Diabetes mellitus, coronary artery disease, end-stage renal failure, peripheral arterial disease and prior lower extremity amputation were significant risk factors for multiple upper extremity amputations. One-year, 2-year and 5-year mortality rates were 12%, 15% and 38%, respectively, following first upper extremity amputation. The risk factors for upper extremity amputations correspond with those for lower extremity amputations, comprising mainly diabetes mellitus and its related comorbidities. The mortality rates for non-traumatic upper extremity amputations highlight their significant burden on patients. Level of evidence: III

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