patients with diabetic foot ulcer in a tertiary health facility in north central Nigeria
INTRODUCTION: Diabetic foot ulcer is a complication of diabetes mellitus of great public health importance. It has the potential of leading to the dreaded sequelae of lower extremity amputation. This outcome is associated with significant morbidity and mortality, hence the need to explore its predictors among persons with diabetic foot ulcers.
METHODOLOGY: The study involved the review of the medical records of seventy (70) in-patients who had received treatment for diabetic foot ulcer at the Federal Medical Centre, Keffi, North Central Nigeria. In addition to obtaining sociodemographic and medical history, information on the Wagner grade of the ulcer, the presence of peripheral sensory neuropathy (using the 10g monofilament) and the presence of osteomyelitis (using plain X-ray of the foot) were obtained and documented. The prevalence rate of lower extremity amputation was also determined.
RESULTS: The study population comprised 52.9% males and 42.1% females. The mean age for male and female participants were 53.4±10.5 and 58.8±13.0 years respectively ( t = 2.35; p = 0.061). Majority of study subjects (37.1%) had Wagner grade 2 disease. Prevalence rate of amputation was 38.6%. Among the potential predictors of lower extremity amputation analyzed (Age, sex, foot care education, duration of diabetes, cigarette smoking, walking bare feet, impaired vision, peripheral neuropathy, hypertension, previous foot ulcer, osteomyelitis), none of them demonstrated a significant association with lower extremity amputation.
CONCLUSION: The list of potential predictors of lower extremity amputation considered in this study is by no means exhaustive. More studies involving larger study populations and other potential predictors of lower extremity amputation not considered in this work (such as peripheral artery disease and glycated haemoglobin) are encouraged.
SHERIDAN — After working as an orthopedic surgeon for 20 years, Dr. Scott Nickerson was forced into an early retirement by diabetes.
After graduating from the Johns Hopkins University School of Medicine, Nickerson moved to Sheridan in 1977 to work as an orthopedic surgeon at Sheridan Orthopaedics, which was a small three-doctor practice at the time.
One of the many complications of diabetes is neuropathy, nerve damage that can lead to pain, weakness and loss of sensation in the extremities.
Nickerson said after living with diabetes for about 10 years, he began to notice his hands were getting clumsy.
“I would drop tools a little bit or just not have quite the sensation you would depend on to do the work,” Nickerson said. “Plus it would hurt me a lot to be on my feet.”
Nickerson decided to retire so the effects of his neuropathy would not affect his work as a surgeon … read more