King-Martínez AC, Tenorio-González B, Jardon-Gomez A, Ramos-Morales R, Cuellar-Avaroma A

Language: English
References: 15
Page: 219-226
PDF size: 705.39 Kb.

ABSTRACT

Introduction: diabetic foot is one of the most prevalent and clinically significant complications of diabetes mellitus. Early identification of structural, neuropathic, and dermatologic risk factors is imperative to prevent ulcer formation and subsequent lower-extremity amputation. The objective of this study was to assess the frequency of podiatric alterations, self-care deficiencies, and structural abnormalities that could associate with ulcer development in an ambulatory diabetic population. Material and methods: a cross-sectional study was conducted, encompassing patients diagnosed with diabetes mellitus who attended an internal medicine outpatient clinic and later underwent a standardized orthopedic foot evaluation. The data presented herein were obtained through the utilization of a structured questionnaire and a bilateral physical examination. The demographic variables, symptoms and findings were meticulously documented. A comprehensive descriptive statistical analysis and a series of bivariate analyses were conducted. Results: this study encompassed a total of 302 patients, with 594 feet being analyzed in the course of the research. Objective neuropathy, as determined by 10-g monofilament testing, was identified in 8.9% of patients; whereas neuropathic symptomatology was considerably more prevalent (paresthesia 76.8%, numbness 66.2%). Dermatological and mechanical alterations were frequently observed. Xerosis was present in 84.1% of cases, maceration in 66%, and erythema in 11.8%. Hyperkeratosis was present in 90.4% of patients, and claw toe deformity was observed in 32.1%. Active ulceration was identified in 7% of patients, and amputation was present in 5.6% of cases, with 55.6% of these amputations being classified as major. Conclusions: ambulatory patients suffering from diabetes exhibited a high frequency of structural deformities, dermatological alterations, neuropathic symptomatology, and suboptimal self-care habits. This established a phenotype associated with ulceration. The implementation of early orthopedic screening and systematic risk modification strategies has the potential to prevent limb-threatening complications and enhance long-term quality of life.

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