P63
Some Features Of Foot Ulceration in Nigerians With Diabetes Mellitus
Ogbera Anthonia.Okeoghene, Department of Medicine, Lagos State University
Teaching Hospital, Lagos, Nigeria.
Adedokun A, Department of Family Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria.
Background/Introduction: Diabetes mellitus foot ulceration (DMFU) is an important complication of diabetes mellitus (DM). It often has grave implications to the patient and the larger society. There is a dearth of information on DMFU in Nigerians living with diabetes. It is hoped that the information gleaned from this study will not only heighten awareness of DMFU in Nigerians but also be of importance to the clinicians/care givers and people with DM.
Aims/Objectives: This study sets out to describe some of the salient features of foot ulceration in Nigerians with DM. The study aims to highlight the demographic characteristics, risk factors, precipitants amongst other characteristic features of this all important diabetes complication.
Subjects and Methods: 47 subjects with diabetes mellitus with past/present foot ulceration were studied over a period of one year. Demographic characteristics of these people were documented. Features of neurological and peripheral vascular disease were sought for from the history and physical examination that involved the use of the tuning fork, Semmes-Weinstein filament and Doppler’s studies. Glycaemic control was assessed and for some of them, foot ulcers were graded using the Wagner’s grading system.
Results: People with type 1 were 7(15%) while those with Type 2 made up (85%).The mean age SD of these subjects with DMFU was 56(11.2). There was a statistically significant difference in the ages of those with Type 1DM and those with Type 2DM. Neuropathy was detected in 87% of the subjects while Peripheral vascular disease was documented in 30% of them. Of note is that PVD was documented only in those with Type 2DM. A large majority had poor glycaemic control and long duration of DM. This not withstanding, the diagnosis of DM was made in 12(26%) of them at presentation with foot ulceration. The commonest precipitant of DMFU was the occurrence of spontaneous blisters. Over half of the subjects had Grades 4 and 5 foot lesions using the Wagner’s grading system.
Conclusion:/Recommendation: Foot ulceration may be the first presenting feature of DM. PVD is nor as uncommon in Africans as previously documented. Neuropathy is a dominant feature of DMFU. More in-depth studies are necessary in order to characterize the peculiarities of foot ulceration in Nigerians with DM.