THE SWEET FOOT Relation of Glycemic Control with Diabetic Foot Lesions

Abstract

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.