Endocrine Abstracts

Introduction: The complications related to ulcerated foot lesions are a common cause of hospitalization among diabetics. Diabetic foot infection is associated with high morbidity and is the most common precipitating factor to precede amputations of the lower limbs.

Methods: Retrospective, cohort study; were included 200 patients from the Diabetic Foot consultation of the Endocrinology Department between 1 January and 31 August 2015. Ulcerated lesions were classified according to the infection part of the PEDIS classification of the IWGDF.

Results: Our sample consists in 84.5% of patients with type 2 diabetes mellitus, mean age 62.5±13 years and mean duration of disease of 17.7±13 years. Regarding the classification of foot, 57.5% were classified as neuroischemic diabetic foot. Of the 200 patients, 51% had active ulcers classified in 31.5% of the patients as grade 1 (n=63).

Concerning the therapeutic, 77.5% of the patients were under insulin therapy. Despite the trend towards higher number of patients on insulin therapy in higher categories of infection, this did not reach statistical significance (P=0.105).

The presence of diabetic retinopathy (P=0.022), previous history of ulcers (P=0.000) and osteomyelitis (P=0.000) and higher values of HbA1c (P=0.002) were associated with a significant increase in the severity of infection.

The existence of previous microbiological studies were associated with clinically more severe infections probably related to the bias of higher patient risk profile whom studies are requested (P=0.000).

Patients with no personal history of revascularization surgery (P=0.019) and no history of smoking (P=0.048) were associated with lower ulcerated lesion classification categories.

Conclusion: Diabetic foot ulcers are highly prevalent and are associated with high morbidity and mortality. The presence of diabetic retinopathy, previous history of ulcers and osteomyelitis and higher HbA1c values have an impact with statistical significance in the direction of worsening infection category.