Screening Techniques to Identify Occurrence of Diabetic Foot Ulceration Among People at High Risk

Abstract

Background Foot ulceration is an important health issue associated with significant levels of disability, pain and financial expense for those affected. Furthermore, foot ulcers can become life threatening when complicated by infection and might result in amputation when lesions don"t heal. Aim:-. Screen the occurrence of diabetic foot ulceration among people at high risk. Subjects and methods Prospective (cohort) study at Port Said city, 300diabetic patients were screened and followed twice, after three and six months. Three tools were used for data collection. Diabetic patient knowledge schedule, diabetic foot examination checklist, and foot ulcer checklist assessment. The patients were examined for presence of diabetic peripheral neuropathy , autonomic neuropathy ,sensory deficit , peripheral vascular disease , foot deformity , skin and nail problems. Patients were graded using (The international consensus on diabetic foot risk category 1999), according to their risk category. Results:-The following variables were significant risk factors with occurrence of diabetic foot ulcerations: previous foot ulcer, peripheral neuropathy, autonomic neuropathy, presence of other diabetic complications, retinopathy, diabetes duration and mean age group (53.14 ± 9.20). Ulcerations occur in 7.3% of studied sample after three and six months. Assessment of foot perception using monofilament had the best sensitivity. Peripheral neuropathy was observed in (27.3%) ,peripheral vascular disease was diagnosed in (40%) of studied sample , foot deformity (10.3%) .Recommendations .All patients with diabetes should be screened at least annually for evidence of risk factors for foot ulceration including neuropathy and vascular disease. Foot screening programs that identify those feet at risk should to be taught to all health care professionals involved in the care of the diabetic patient. Conclusion:-previous foot ulcer, peripheral neuropathy, autonomic neuropathy, presence of diabetes complications, retinopathy , mean age group (53.14 ± 9.20) and long duration of diabetes were significant risk factors related to occurrence of diabetic foot ulceration