Category: Diabetes/Prediabetes/Hypoglycemia

Type: e-Poster

Monitor: 22

22 - EPIDEMIOLOGIC AND CLINICAL CHARACTERISTICS OF DIABETIC FOOT ULCERS - REPORT FROM SOUTH WEST NIGERIA

Thursday, Apr 25
11:00 AM – 11:30 AM

Objective :

Diabetes foot ulcers (DFUs) are disabling complications of Diabetes Mellitus(DM). The burden of DFUs is still high in resource poor settings which Nigeria belongs. We aim to document the epidemiology, clinical characteristics, frequency and management outcomes  of diabetic patients admitted for DFUs at the Lagos State University teaching hospital (LASUTH) Lagos Nigeria, over a one year period and compare with data reported from same center 10 years previously.


Methods :

:  Prospective Cross-sectional study  from January 2016 to January 2017. Consecutive diabetic patients admitted to LASUTH medical wards with diabetic foot ulceration. Data compiled from patients hospital records while on admission and were followed up for three months after discharge.


Results :

150 patients with DFUs were admitted during study period, of which 112 had adequate data. Mean age 58 ±11.0 yrs. Youngest 35, oldest 87yrs. 51% males, 49% females. Majority (31%) were  in 51-60years age category. Most were actively engaged in an occupation (82%). 18% were retired. Over 90% do not smoke cigarettes. Mean duration of DM is 8.32 ±7.27yrs. 67% never had foot care education. Ulcer was of spontaneous onset in 54% of subjects. Mean duration of ulcer at presentation was 72.07 ±138.13 days. 48.2% had Wagner grade 4 ulcer, 25.5% grade 3; 16.4%grade 2 ; 7.3% grade 5 ; 2.7% grade1 . 31% had foot deformity. 80% had symptoms of neuropathy. 63% had evidence of Peripheral arterial disease(PAD). 22% had past history of DFU. 55% walk barefoot. 24% had x-ray evidence of osteomyelitis. Mean HbA1c  was 9.9%,. 53% were hypertensive. 58% were anaemic. 35% had amputation. 16 died. Case fatality of 10.6%.


PAD is a significant factor of death (P-value = 0.006, O.R = 40.792, C.I = 2.847 – 584.378).


Discussion : There were more males than females, with majority of subjects being in the productive age group. Significant number had no previous diabetic foot care education because they were presenting to the hospital for the first time with the complication of DFU. Over half of the patients presented with advanced foot ulceration. An earlier study on DFU conducted 10 years previously reported a case fatality of 16%. We observed a case fatality of 10.4% in this study.


Conclusion :

Late presentation is  common amongst patients with DFU in our setting as such there should be concerted efforts to improve  patient education, access to health care, and provision of multidiciplinary care to reduce the high rate of amputation. Case fatality of DFUs although still unacceptably high, is on a downward trend. 

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Olufunmilayo O. Adeleye

Consultant Physician/Endocrinologist
Lagos State University Teaching Hospital. 1-5 Oba Akinjobi Way , Ikeja Lagos Nigeria
Lagos, Lagos, Nigeria

I am a Consultant physician Endocrinologist. I graduated from the College of Medicine University of Lagos. I am a fellow of the West Africa College of Physicians.

Ejiofor Ugwu

Consultant Physician/Endocrinologist
Enugu State University Teaching Hospital, Enugu, Nigeria
Enugu, Nigeria

I am a consultant Physician Endocrinologist and Diabetologist at Enugu State University Teaching Hospital, Enugu, Nigeria. I am also a senior lecturer at the depertment of Internal Medicine, College of Medicine, Enugu State University of Science and Technology. I am the National Vice president of Diabetes Association of Nigeria.

Anthonia Ogbera

Consultant Physician/Endocrinologist
Lagos State University College of Medicine 1-5 Oba Akinjobi Way Ikeja Lagos
Lagos, Lagos, Nigeria

Current Provost of the Lagos State University college of Medicine. Honorary Consultant to the Lagos State University Teaching Hospital Ikeja Lagos Nigeria.

Akinola Dada

Consultant Physician/Endocrinologist
Lagos State University College of Medicine 1-5 Oba Akinjobi Way Ikeja Lagos

Consultant Physician endocrinologist. Honorary Consultant to the Lagos State University Teaching Hospital Ikeja Lagos Nigeria. Senior Lecturer LASUCOM.

Ibrahim Gezawa

Consultant Physician/Endocrinologist
n/a

consultant physician endocrinologist

Innocent ONOJA.. Okpe

Consultant Physician/Endocrinologist
Ahmadu Bello University Teaching Hospital
Zaria, Kaduna, Nigeria

consultant physician/endocrinologist and Senior Lecturer at the Ahmadu Bello University , a foremost University in Northern Nigeria and center of excellence.

Ignatius Ezeani

Consultant Physician/Endocrinologist
Federal Medical Center Umuahia
Umuahia, Abia, Nigeria

consultant physician / endocrinologist

Marcelina Enamino

Consultant Physician/Endocrinologist
Federal Medical Center Keffi

Consultant Physician/ Endocrinologist

Olufunmilayo O. Adeleye

Consultant Physician/Endocrinologist
Lagos State University Teaching Hospital. 1-5 Oba Akinjobi Way , Ikeja Lagos Nigeria
Lagos, Lagos, Nigeria

I am a Consultant physician Endocrinologist. I graduated from the College of Medicine University of Lagos. I am a fellow of the West Africa College of Physicians.