Assessment of the Podiatric Risk on Diabetics in Dakar Hospital Area: Cross-Sectional Study in Regard to 142 Patients

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 posterior ly 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.