Comorbidities associated with Egyptian diabetic foot disease subtypes

Abstract

Introduction Diabetic foot problems are highly prevalent, responsible for almost 50% of all diabetes-related hospital admissions and a 10-year reduction in life expectancy. The main factors involved in the pathology of diabetic foot are neuropathy, ischemia, and infection. The comorbidities of diabetes are hypertension, obesity, and dyslipidemia. Because of the huge premature morbidity and mortality associated with diabetes, prevention of complications is a key issue and, therefore, it is essential to understand the basic mechanisms that lead to tissue damage. Aim of the work The aim of our study was to detect the association between patient comorbidities, chronic complications, and different diabetic foot types for the early detection and management of these conditions. Patients We carried out a cross-sectional study of 80 consecutive outpatient Egyptian patients with diabetic foot disease in the National Institute of Diabetes and Endocrinology. Results Sixty-three percent were purely neuropathic, followed by 19% that were neuroischemic, whereas 18% were of the ischemic type. Hypertension is the most common comorbid condition and coronary artery disease is highly prevalent in the ischemic and neuroischemic types. The coexistence of hypercholesterolemia, smoking, diabetes, and male sex appears to significantly increase the incidence of ischemic diabetic foot. Nephropathy and retinopathy are significantly associated with neuropathic foot ulcers. Hypertriglyceridemia correlates positively to ischemic and neuroischemic ulcers whereas low HDL and proteinuria correlate positively to both neuropathic and neuroischemic ulcers. Conclusion Special attention should be paid toward the identification of patients who are at risk of foot ulceration to help prevent foot problems. Comorbid conditions must also be identified early and managed aggressively.