Endocrine Abstracts

Introduction: The prevalence of type 2 diabetes mellitus (DM) is increasing worldwide. As a result, there is also an increased incidence of complications of diabetes at the clinics and emergency rooms. This study seeks to know the proportion of medical admissions due to diabetes-related causes, to determine the pattern of DM-related admissions, assess the pattern and outcome of diabetic foot syndrome (DMFS) and their determinants.

Method: We conducted a retrospective descriptive study at the Federal Medical Centre Owo, South-West Nigeria. Medical records of patients admitted for medical conditions from 2016 to 2020 were obtained. We recorded the total number of medical cases and specifically noted diabetes-related conditions. Demographic data, clinical history, examination findings and laboratory results of patients admitted for DMFS were recorded.

Results: Four hundred and fifty subjects were admitted due to diabetes-related causes. Of these, DMFS accounted for 20.2%, Diabetic Ketoacidosis (DKA) 1.8%, Hypoglycemia 4.2%, Hyperglycemic hyperosmolar state (HHS) 18.2%, cerebrovascular accident (CVA) 0.4%, DM nephropathy 17.8%, DM hand 0.7%, poor glycemic control 35.8% and gluteal ulcer 0.9%. Nearly an equal number of males and females had DMFS. Among these patients, 55% presented with Wagner grades 4 and 5 ulcers, of which 81.8% eventually had amputation. We employed a multinomial logistic regression model to assess the risk factors associated with mortality from DMFS. The analysis revealed that higher grades of ulcer, elevated levels of serum urea, serum creatinine, TWCC, adSBP, adRBS, and lower PCV were all associated with an increased mortality risk.

Conclusion: The study highlights a high proportion of diabetic-related admissions related to diabetic foot ulcers. The study findings indicate that most cases presented with foot gangrene, leading to limb amputation. It emphasizes the need for prioritizing foot care education in diabetes clinics to address this issue effectively.

Keywords: Diabetes mellitus, Diabetic foot ulcer, Diabetic foot outcome