Impact of a diabetic foot care education program on lower limb amputation rate

Abstract

BackgroundDiabetic foot complications are a leading cause of lower extremity amputation. With the increasing incidence of diabetes mellitus in the Arab world, specifically in the Kingdom of Saudi Arabia, the rate of amputation will rise significantly. A diabetic foot care program was implemented at King Abdulaziz Medical City in Riyadh, Saudi Arabia, in 2002. The program was directed at health care staff and patients to increase their awareness about diabetic foot care and prevention of complications. The purpose of this study was to perform a primary evaluation of the program’s impact on the rate of lower extremity amputation due to diabetic foot complications.MethodThis pilot study was the first analysis of the diabetic foot care program and examined two groups of participants for comparison, ie, a “before” group having had diabetic foot ulcers managed between 1983, when the hospital was first established, and 2002 when the program began and an “after group” having had foot ulcers managed between 2002 and 2004, in the program’s initial phase. A total of 41 charts were randomly chosen retrospectively. A data sheet containing age, gender, medical data, and the presentation, management, and outcome of diabetic foot cases was used for the analysis.ResultsThe before group contained 20 patients (17 males) and the after group contained 21 patients (16 males). There was no difference between the two groups with regard to age and comorbidities. The rate of amputation was 70% in the before group and 61.9% in the after group. There was a decrease in the percentage of toe amputation in the after group and an increase in the percentage of below-knee amputation in the before group. However, these changes were not significant.ConclusionThe program, although evaluated at an early stage, has increased the awareness of both patients and health care staff about the prevention and management of diabetic foot disease, and decreased the rate of lower extremity amputation. We believe that the statistical proof of its impact will be evident in the final evaluation.

A developing world experience with distal foot amputations for diabetic limb salvage

“…Early surgery and foot-care programs have decreased major amputations up to 80% in developed countries (20). In our study, subsequent amputation rate was 11% which correlates with studies by Frykberg et al (21), Al-Wahbi (22), and Cavanagh et al (23). …”

Diabetic Foot Care: Knowledge and Practice

“…Although there are significant studies in Saudi Arabia about DF and its complication [11][12][13][14][15], studies in Jazan region are scanty. The main objective of this study was to measure the knowledge level among diabetic patients about DF and to assess the adherence level among diabetic patients to foot care.…”

Illiteracy and diabetic foot complications

“…Diabetes is common in the Gulf countries; and diabetesrelated foot problems are expected to be numerous, especially since illiteracy is exceptionally prevalent in our region (more prominent in the females) and podiatrist care services are still limited in the UAE [23][24][25].…”