Prospective Observational Study: Risk Factors and Outcomes of Diabetic Foot Ulcer among Diabetes Mellitus Patients Admitted to Government Medical College, Nizamabad
Madhukar Sirasu *
Department of General Surgery, Government Medical College, Nizamabad, Telangana, India.
C. Ramchandraiah
Department of General Surgery, Government Medical College, Nizamabad, Telangana, India.
C. Muralidhar
Department of Pharmacology, Government Medical College, Suryapet, Telangana, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Diabetes mellitus (DM), sometimes known as diabetes, is a collection of metabolic illnesses defined by a persistently high blood sugar level. Frequent urination, increased thirst, and increased appetite are common symptoms. In all nations, DM complications have become a serious public health issue.
Objectives: A hospital-based study, a prospective observational study was conducted among diabetic patients with diabetic foot ulcers at Government Medical College (GMC), Nizamabad. From September 2020 to October 2021
Materials and Methods: To calculate the sample size, a total population of 450 patients with type 2 DM diagnosed during the 6-month study period was considered. DFU patients were studied clinical characteristics of diabetic foot ulcer patients among diabetes mellitus patients, and risk factors and outcomes of diabetic foot ulcer.
Results: 100 Diabetic foot ulcers (DFU) patients were admitted to the GMC throughout the research period, with 61 (61%) of them being male. The age group between 18 to 78 years, with an average of 58.9 ± 9.56 years. The following groups had higher frequencies among participants: married 56 (56 %), schooling up to primary school 36 (36%). Type 2 diabetes mellitus affected 59 of them (59%). Amputations were performed on 35 (35%) of the patients, whereas 65 (65%) had no amputation. The most generally recommended antibiotic for the treatment of DFU was cloxacillin + metronidazole 39 (39%), followed by ceftriaxone. Furthermore, diabetic foot ulcer patients with neuropathy were more likely to require amputation (AOR = 1.6250; 95 % CI: 0.6479, 4.0756) than diabetic foot ulcer patients without neuropathy.
Conclusion: Blood glucose level, higher body mass index, inappropriate antibiotics use, neuropathy and advanced grade of diabetic foot ulcer were independent predictors of amputation. Thus, a focus on weight loss, treating hyperglycemia, and prescribing suitable antibiotics for patients with neuropathy and advanced diabetic foot ulcers might reduce the unfavorable consequences of diabetic foot ulcers.
Keywords: Diabetic foot ulcer, diabetes mellitus, amputations, cloxacillin, metronidazole