Endocrine Abstracts

Introduction: The screening of patients at diabetic foot risk and the implementation of prevention measures are justified by the frequency and severity of amputations.

The aim of this study was to:

– Screen diabetic feet at risk.

– List the risk factors associated with the diabetic foot at risk.

– Present the methods of management of diabetic foot at risk in our service.

Patients and methods: It was a prospective and observational study, conducted in our department outside patients with recent type 1 diabetes (<5 years), diabetic pregnancies, and patients with non-neuropathy diabetic. Statistical analysis was performed by SPSS software version 19.

Results: We Included 482 patients whose average age was 47.7 years and sex ratio was 1.6. Type 2 diabetes was predominant in 69% of cases, 58% were sedentary, 40% were obese, 42% were hypertensive patients, 48% were dyslipidemic and 12% were smokers. Diabetic nephropathy was present in 36% of cases. According to the IWGDF classification, 24% were at low risk of ulceration, 22% were at moderate risk, 26% were at high risk and 28% at very high risk. The level of risk was significantly correlated (P<0.005) with age, age of diabetes, dyslipidemia, obesity, smoking, physical inactivity and nephropathy. All patients benefited from a therapeutic education. A diabetic foot day was organized every 2nd Wednesday of the month, bringing together an average of 10 to 12 high-grade patients for re-education. Patients with arteriopathy obliterans of the lower limbs were put on treatment and referred for specialist advice. Long-lasting footwear and adapted prostheses are prescribed in consultation with physicians in patients with deformity, corrective surgical management is planned. Over 1 year, among 482 patients, 6 patients with multi-complicated diabetes and grade 3 feet developed a foot injury requiring hospitalization.

Conclusion: The gradation of the podological risk is based exclusively on the clinical examination. Thereafter, patient awareness and education about PD are paramount.