A STUDY OF DIABETIC FOOT ULCER AND ITS CORRELATION WITH NEUROPATHY, PERIPHERAL VASCULAR DISEASE AND GLYCEMIC CONTROL

Diabetes is one of the endocrine disorders that reached epidemic proportions worldwide. The metabolic deregulation associated with diabetes mellitus (DM) causes secondary path physiologic changes in multiple organ systems that impose a tremendous burden on the individual with diabetes. Diabetic foot ulcer is becoming major concern of diabetic patients. The vascular insufficiency and neuropathy accompanying the diabetic foot most often necessitate amputation of the limb. With the above considerations we undertook the study of 50 patients of diabetic foot admitted in our institute over a period of 2 years and 6 months. The mean age of study subjects was 53.18 ± 12.89 years. Male predominance was observed in study subjects with male to female ratio of approximately 5:1. 52% had BMI above 30. Clinical examination of ulcers for grading revealed that the percentage of grade IV lesion was highest (44%) followed by grades III (24%). Maximum diabetic foot ulcers patients had duration between 8 -12 years. 36% of diabetic foot ulcer patients had HBA1c between 8.6-9.5%. There is strong correlation between various grades of diabetic foot ulcers and peripheral neuropathy. Males (76%) had higher signs and symptoms of peripheral neuropathy as compared to females (24%). The most common clinical presentation of peripheral neuropathy was intermittent claudication (28%), paresthesia (26%) and numbness. Our study also identified some important risk factors for diabetic foot ulcers including older age, long duration of diabetes, lack of awareness of this disease, poor glycemic control and rural residence of patients. Sensory neuropathy was also found to be important risk factors for diabetic foot complications.