Clinical predictors of imminent diabetic foot ulcer among diabetes mellitus patients in Dar es salaam and Zanzibar
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Date
2024-05
Journal Title
Journal ISSN
Volume Title
Publisher
IOSR Journal of Dental and Medical Sciences
Abstract
Background: Diabetic foot ulcer (DFU) is a lesion that involves breakage in the skin with loss of epithelium that
extends to the dermis and deeper layers involving muscle and bone which tend to develop due to factors associated
with diabetes; hyperglycemia, presence of calluses, foot deformities, peripheral neuropathy, and vasculopathy.
The management of diabetic foot ulcers requires a multidisciplinary approach; and is burdensome on the health
care systems due to its chronic nature and potential complications. Diabetic foot ulcer has caused financial
distress to the government in treating diabetic foot ulcer and its consequences; such as lower limb amputation
which is irreversible, costly, and devastating to the quality of life of the patients, since diabetic foot ulcer patients
have a low work productivity which in turn causes them to remain unemployed. DFU leads to increased morbidity
and mortality due to complications like sepsis. Identification of the clinical predictors of imminent diabetic foot
ulcer among diabetes mellitus patients is pivotal for the prevention and prompt identification of diabetic foot
ulcer. This study aimed to identify and outline the clinical predictors of imminent diabetic foot ulcer among
diabetes mellitus patients in Dar es Salaam and Zanzibar.
Hence, identifying the clinical predictors of imminent diabetic foot ulcer such as; peripheral neuropathy for
example which usually goes unnoticed because of its oblivious nature will therefore have no room for excuse and
further prevent the development of diabetic foot ulcer. Correspondingly it allows health care systems to distribute
access to health care rather than focusing on treating DFU significantly. It will also enable the government’s
economic burden placed on managing DFU to temper down. The quality of life of patients will improve in terms
of physical, mental, and social health hence, reducing morbidity and mortality.
Methods: a descriptive cross-sectional study was conducted among diabetes mellitus patients attending diabetic
clinics in Dar es Salaam and Zanzibar. Questionnaires were used to collect demographic data and clinical
characteristics of study participants. Random blood glucose and skin scrape tests were done using standard
methods.
Results: A total of 202 participants (72 males and 130 females) were studied. The overall mean age of the study
participants was 55.3± 16.7 years with a range of (13-83 years). The majority of the participants resided in Dar
es Salaam, with 164 (81.2%) individuals, while 38 (18.8%) were from Zanzibar. Out of the 202 study participants,
the proportion of diabetic foot ulcer was 40.6%, with the clinical predictors of imminent diabetic foot ulcer;
peripheral neuropathy (47%), calluses (43.1%), hyperglycemia (34.2%) foot deformities (20.8%) and peripheral
vasculopathy (10.4%).
Conclusion: findings from this study provide evidence for the existence of clinical predictors of imminent diabetic
foot ulcer among diabetes mellitus patients in which peripheral neuropathy, calluses, hyperglycemia, foot
deformities, and peripheral vasculopathy predominate.
Description
Keywords
Diabetic foot ulcer, Clinical predictors, Neuropathy
Citation
Lwabukuna,W.C.,Mgonda,Y.M.,2024.Clinical predictors of imminent diabetic foot ulcer among diabetes mellitus patients in Dar es salaam and Zanzibar.