Prevalence and pattern of Diabetic Foot Ulcers among adults with Diabetes mellitus in a secondary health care facility in Lagos, Nigeria
Keywords:Prevalence, Pattern, Diabetic foot ulcer, Secondary Health Care Facility, Nigeria
Introduction: The prevalence of diabetes mellitus with the attendant complications is increasing worldwide, contributing significantly to the health and socioeconomic burden of individuals, family and health care system.
Objective: To determine the prevalence and pattern of diabetic foot ulcers recorded among patients with diabetes at the General Hospital Marina, Lagos.
Methods: A descriptive cross-sectional study involving all the consecutively recruited attendees at the Out-patient Clinic was conducted between February and July 2014 using a semi-structured questionnaire.
Results: Six hundred and twenty adults were invited to the study out of which 8 declined, giving a response rate of 98.7%. The mean age of the participants, mostly females (78.9%), was 61.1±11.0 years. The subjects had lived with diabetes mellitus for more than 3years (76.3%) and had a mean blood glucose level of 136.4±59.7mg/dl. Over two-thirds of them (79.6%) were receiving oral anti-diabetic drugs with a history of poor drug compliance in more than three-quarters (485; 79.2%). The prevalence of Diabetic Foot Ulcer was 17.3%; these presented as swelling (37; 34.9%), blisters (33; 31.1%), trauma (25; 23.6%) and burns (11; 10.4%). The prevalence was associated with female gender and age above 60 years (p = 0.0001 and p = 0.005 respectively). None of the other socio-demographic characteristics had significant association with the presence of diabetic foot ulcers.
Conclusion: This study revealed a high prevalence of diabetic foot ulcers, especially among the elderly females. Patient education on diabetes should include foot care as this may reduce its prevalence and burden.
Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998; 15(7): 539-53.
Isla Pera P; American Diabetes Association. Chronic complications of diabetes mellitus. Recommendations from the American Diabetes Association 2011. Prevention and management. Rev Enferm 2012; 35(9): 46-52
International Diabetes Federation Atlas 7th edition 2015 in Executive summary, Diabetes: A global emergency. Available from : https://www.diabetesatlas.org Accessed on the 17th January 2017.
Unadike BC, Eregie A, Ohwovoriole AE. Prevalence of hypertension amongst persons with diabetes mellitus in Benin City, Nigeria. Niger J Clin Pract 2011; 14(3): 300-2. doi: 10.4103/1119-3077.86772.
Eregie A, Edo AE. Factors associated with diabetic foot ulcers in Benin - City, Nigeria. Niger Med J 2008; 49(1): 9-11.
UK Prospective Diabetes Study (UKPDS) Group Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998; 352(9131): 837-53.
Peer N, Kengne AP, Motala AA, Mbanya JC. Diabetes in the Africa Region: an update. Diabetes Res Clin Pract 2014; 103(2): 197-205.
Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA 2005; 293(2): 217-28.
Wagner FW. The dysvascular foot: a system for diagnosis and treatment. Foot 1981; 2; 64-122.
Brownlee M, Aiello LP, Cooper ME, Vinik AI, Nesto A, Boulton AJM. The diabetic Foot in Complications of Diabetes Mellitus In: Krononberg NH, Sholmo M, Polonsky KS, Larsen PR (Eds). Williams Textbook of Endocrinology. 11th Edition. Saunders Elservier; 2008: pp1478.
Boulton AJM, Vileikyte L, Kirsner RS. Neuropathic diabetic foot ulcers. New Eng J Med 2004; 251: 48-55.
Solagberu BA. Diabetic foot in Nigeria- a review. Afr J Med Med Sci 2003; 32(2): 111-8.
Ekpebegh CO, Iwuala SO, Fasanmade OA, Ogbera AO, Igumbor E, Ohwovoriole AE. Diabetes foot ulcer in a Nigerian teaching hospital: in-hospital mortality in relation to presenting demographic clinical and laboratory features. Int Wound J 2009; 6(5): 281-5
Ogbera AO, Adedotun A, Fasanmade OA, Ohwovoriole AE, Ajani M. The foot at risk in Nigerians with Diabetes Mellitus - The Nigerian Scenario. Int J Endocrinol Metab 2005; 4: 165-73.
Musa AA. Diabetic foot as seen in Nigerian teaching hospital: pattern and a simple classification. East Afr J Public Health 2012; 9(1): 50-2.
Ogbera AO, Fasanmade O, Ohwovoriole AE, Adediran O. Assessment of the disease burden of foot ulcers in patients with diabetes mellitus attending a teaching hospital in Lagos Nigeria. Int J Lower Extrem Wounds 2006; 5(4): 244-49.
Isara AR, Okundia PO. The burden of hypertension and diabetes mellitus in rural communities in southern Nigeria. Pan Afr Med J 2015; 20: 103. doi: 10.11604/pamj.2015.20.103.5619.
Chinenye S, Uloko AE, Ogbera AO, Ofoegbu EN, Fasanmade OA, Fasanmade AA et al. Profile of Nigerians with diabetes mellitus – Diabcare Nigeria study group (2008): Results of a multi-center study. Indian J Endocrinol Metab 2012; 16(4): 558–64. doi: 10.4103/2230-8210.98011
Abbott, CA, Carrington AL, Ashe H, Bath S, Every LC, Griffiths J, et al. The North-West Diabetes Foot Care Study: incidence of, and risk factors for, new diabetic foot ulceration in a community-based patient cohort. Diabet Med 2002; 19(5): 377-84.
Odusan O, Ogunsemi OO, Olatawura OO. Common mental disorders among subjects with T2DM in Sagamu Nigeria. Afr J Med Med Sci 2012; 41: 141-45.
Barham D, Trinder P. An improved colour reagent for the determination of blood glucose by the oxidase system. Analyst 1972; 97: 142-45.
Odusan O. Diabetic Foot Ulcers - Improving Outcome. Nigerian Endocr Pract 2010; 4(2): 11-8.
Ojieabu WA, Odusan O, Ojieabu NI, Oku LM. Evaluation of prevalence of Micro and Macrovascular Complications among Elderly Type 2 Diabetes Patients in a Health Facility. Afr J Biomed Res 2017; 20: 131-35.
Oyibo SO, Jude EB, Tarawneh I, Nguyen HC, Armstrong DG, Harkless LB, et al. The effect of ulcer size and site, patient’s age, sex and type and duration of diabetes on the outcome of diabetic foot ulcers. Diabet Med 2001; 18 (2): 133-38.
Boulton AJM. The diabetic foot: from art to science. Diabetologia 2004; 47: 1343-53.
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