TITLE:
Assessment of the Podiatric Risk on Diabetics in Dakar Hospital Area: Cross-Sectional Study in Regard to 142 Patients
AUTHORS:
Abdoulaye Leye, Ngone Diaba Diack, Yakham Mohamed Leye, Nafy Ndiaye, Alex Bahati, Ameth Dieng, Daouda Thioub, Maïmouna Senghor, Maouly Fall, Samira Elfajri
KEYWORDS:
Foot Risk, Diabetes, Dakar
JOURNAL NAME:
Journal of Diabetes Mellitus,
Vol.8 No.1,
January
16,
2018
ABSTRACT: The prevention of diabetic
foot goes through a systematic podiatric assessment of diabetic patients
permitting to identify the foot at risk. Then, we realized a study in the
Internal Medicine Department at Pikine Teaching Hospital in Dakar with the
assessment of foot risk on admitted diabetic patients as our main objective. Methods:
It was about a prospective cross-sectional, descriptive and analytic study done
on 18 months period. Results: Overall, 142 patients
were gathered. The average age was 56.22 years and the sex-ratio was 0.67. 87.2% of the patients
were running type 2 diabetes. The capillary blood glucose and glycated
hemoglobin were respectively around 3.24 g/L and 9%. High Blood Pressure was found in 62% of
cases. The type of footwear most used by our patients was sandals (96.3%). Also, 30.6% of patients walked
barefoot. Prior ulceration and/or amputation were noted in 30% of cases. During
the foot examination, a lesion was found in 15.5% of patients. Loss of monofilament sensitivity was
about 66.7%. The Ankle-Brachial Index
(ABI) less than 0.9 was recorded in 34% of
patients and at least a quarter of patients were posteriorly tibial pulselessness. The gradation of the foot
risk according to the International Working Group of the Diabetic Foot (IWGDF)
was established as follow: grade 0 (58%), grade 1 (9.8%), grade 2 (14.3%), grade 3 (17.3%). The presence of neuropathy (OR 12. 162 [3.368 - 43.923]; p = 0.000), plantar keratosis (OR 2.87 [1.119 - 7.399]; p = 0.024) and the absence of pulse perception (OR 9.00 [3.205 - 25.414]; p = 0.000) were significant associated factors of foot injury
occurrence on our patients. Conclusion: The prevention of diabetic foot
in emerging countries is accessible by a systematic clinical examination of all
diabetic feet and the awareness of adapted footwear.