THE SWEET FOOT Relation of Glycemic Control with Diabetic Foot Lesions

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Professor, Consultant Pathologist, American Board Certified Pathologist, Fellow College of American Pathologists. Areas of interest Fine Needle Aspiration Cytology, Cytology, Cancer, Ethics, Islam, Humanity

THE SWEET FOOT Relation of Glycemic Control with Diabetic Foot Lesions

Nighat Akbar* and Nighat Bilal**
* Postgraduate FCPS Trainee, PIMS, Islamabad.
** Professor of General Medicine, PIMS, Islamabad.

Introduction: Diabetes mellitus has become an epidemic in the past several decades, owing to the advancing age of the
population. The average delay of 4-7 yrs in diagnosing type 2 diabetes mellitus translates into approximately 20% of patients
of type 2 diabetes having some evidence of microvascular or neurological diabetic complications at the time of diagnosis.
Material & Method:
Design: Descriptive observational study.
Setting: Out door and indoor patients in P.I.M.S, Islamabad, Pakistan visiting during May to June 7th, 2004 i.e.5 weeks.
Patient Selection: All patients with diagnosed diabetes mellitus eligible to be included in the study.
Measurements included: 1) Glycosylated Hb. 2) Proteinuria by dipstick. 3) Retinal changes by fundoscopy; 4) Skin
lesions 5) Neuropathy such as loss of sensations on self reported history and examination clinically.
Results: Out of a total of 36 patients, males were 39% (n = 14), females 61% (n = 22). Mean age at the time of diagnosis was
42 yrs (15 yrs – 56yrs); mean age at presentation to us was 53 yrs (25-69 yrs); mean duration of diabetes was 15 yrs (I month –
5yrs). Of these patients 94% (n = 34) were taking some form of treatment which included oral hypoglycemics in 94%
(n = 32) and oral and parentral drugs i.e. insulin in 6% (n = 2). Of those taking treatment 56% (n = 20) had controlled diabetes
mellitus (DM) while 44% (n = 16) were having uncontrolled DM at presentation. Mean value of glycosylated haemoglobin
(Hb) was 8.2% (6 – 16.6%).
Conclusion: Incidence of diabetes foot lesion strongly correlates with poor glycemic control which is in itself best
manifested by levels of glycoslated haemoglobin.
Key words: Diabetic foot lesions; Glycemic control.


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