Prevalence of Diabetic Foot Disease in Patients with Diabetes Mellitus under Renal Replacement Therapy in Lleida, Spain

Abstract

Aim. To assess the prevalence of diabetic foot and other associated conditions in patients with diabetes mellitus under renal replacement in the region of Lleida, Spain. Methods. This was an observational, cross-sectional study of 92 dialysis-treated diabetic patients. Besides a podiatric examination, we explored the presence of cardiovascular risk factors, late diabetes complications, including peripheral neuropathy, atherosclerotic disease, and peripheral artery disease. We assessed risk factors for foot ulceration and amputation by logistic regression. Results. Prevalent diabetic foot was found in 17.4% of patients, foot deformities were found in 54.3%, previous ulcer was found in 19.6%, and amputations were found in 16.3%; and 87% of them had some risk of suffering diabetic foot in the future. We observed a high prevalence of patients with peripheral neuropathy and peripheral artery disease (89.1% and 64.2%, resp.). Multivariable analysis identified diabetic retinopathy and advanced atherosclerotic disease (stenosing carotid plaques) as independent risk factors for foot ulceration (p = 0.004 and p = 0.023, resp.) and diabetic retinopathy also as an independent risk factor for lower-limb amputations (p = 0.013). Moreover, there was a temporal association between the initiation of dialysis and the incidence of amputations. Conclusion. Diabetic patients receiving dialysis therapy are at high risk of foot complications and should receive appropriate and intensive foot care.

Prevalence and associated factors of foot ulcer among diabetic patients in Ethiopia: a systematic review and meta-analysis

“…The pooled prevalence of diabetic foot ulcers in Africa is 13.0% that is almost the same as Ethiopia [28]. The prevalence of diabetic foot ulcers in this meta-analysis is lower than a study conducted in Khartoum Sudan, 18.1% [29] and Spain 17.4% [30]. This discrepancy could be due to the difference in the study method.…”

Factors associated with foot ulceration and amputation in adults on dialysis: a cross-sectional observational study

“…Adults with chronic kidney disease (CKD), particularly those with end-stage renal disease (ESRD) requiring dialysis, have an increased risk of foot ulceration and lower extremity amputation [ 1 – 5 ]. As a result, dialysis patients have high rates of foot-related hospital admissions [ 6 ].…”

Risk Factors of Diabetic Foot in Type 2 Diabetic Patients, Menoufia University Hospital, Egypt.

“…Alex et al,2010 (32) , reported that diabetic cases with hypertension seem to be protected against foot complication as most of patients with hypertension in their sample were on ACE inhibitors (Enalapril), which enhanced peripheral circulation. In contrast, Dòria M et al, 2016 3 , reported that "68.5% of diabetic foot patients had dyslipidaemia, and 84.8% of them had hypertension". Regarding self-care practice for safeguarding against diabetic foot, daily foot wash by soap and warm water and dryness after washing were done by significantly higher control population than cases population .Daily foot inspection for early detection of any trauma or infection was neglected by most of cases and control with no significant in between.…”

“…2 Uncontrolled diabetes and peripheral neuropathy were reported as its main risk factors. 3 The diabetic foot may started as simple as minor trauma, impeded toe nail, dryness and inter-digital infections proceeded to ulceration, severe infection, gangrene and amputation. 4 Dealing with preventable risk factors will reduce the cost of hospitalization and management for cases with diabetic foot but this requires first identification of this risk factors and determine it for each patient.…”