MyMedR

Displaying all 6 publications

Abstract:

Sort:

Fulltext Are diabetic foot lesions precipitated by accidental trauma?

Doshi HK, Moissinac K, Harwant S

Med J Malaysia, 2001 Dec;56 Suppl D:29-33.
PMID: 14569763

Diabetic foot lesions may arise from frictional trauma due to tight or inappropriate footwear, repetitive stresses on parts of the foot, overlying bony prominence generated by walking and accidental trauma to the neuropathic foot. Many diabetics have been found to be unaware of their foot lesion, or know what the precipitating cause was. Based on the assumption that accidental trauma would affect the foot in a random fashion and result in lesions distributed evenly throughout the foot, a study was performed to determine whether foot lesions were distributed evenly or concentrated to certain areas of predilection. It was found that foot lesions were not evenly distributed but concentrated to certain areas of predilection. Even though relatively high proportion of the study population walked about in open slippers and barefeet, the study showed that accidental trauma was not a predominant precipitant of diabetic foot lesions. Diabetic foot lesions tend to occur as a result of cumulative, repetitive trauma to areas of prediliection rather than accidental trauma.

Matched MeSH terms: Diabetic Foot/etiology*
Fulltext Bilateral diabetic Charcot foot

Fauzi AA, Yang CT

Aust Fam Physician, 2013 Jan-Feb;42(1-2):55-6.
PMID: 23529463

Charcot neuro-osteoarthropathy (CNO) of the foot is a devastating neuropathic complication of diabetes. It is characterised by deformity of the foot architecture,which can be initiated by trauma to the neuropathic limb or occur spontaneously.The acute phase of the disease is often misdiagnosed and can rapidly lead to deformity and amputation. The aim of management is to halt further bone destruction through immobilisation of the affected limb.

Matched MeSH terms: Diabetic Foot/etiology
Fulltext Foot care strategy for the newly diagnosed DM Type 2 patients with low educational and socio-economic background: a step towards future

Hamidah H, Santhna LP, Ruth Packiavathy RD, Suraya AM, Yap WC, Samsiah M, et al.

Clin Ter, 2012 Nov;163(6):473-8.
PMID: 23306740

BACKGROUND AND AIMS:
Diabetic foot ulcer is one of the major health problems that accounts for increased morbidity among the diabetic patients. Having good knowledge, good attitude and practice of managing the foot prevents the impending chronic co-morbidities of the disease.

MATERIALS AND METHODS:
This cross-sectional study was performed to assess the knowledge, attitude and practice on foot care among the newly diagnosed diabetic type 2 patients with low education and socio economic background. This study was conducted in one of the out patient clinics in a tertiary hospital. A set of questionnaire adopted from The Michigan Diabetes Research and Training Center (MDRTC), was used to assess 109 respondents based on their knowledge of diabetes mellitus, practice and attitude towards the condition and care of the feet.

RESULTS:
The overall finding on knowledge, practice and attitude had shown unsatisfactory result. There was no relationship between the knowledge, practice and attitude with care of the feet. Only 20 (18.3%) respondents had a high score on knowledge, 31 (28.4%) had practiced good habits and 5 (4.6%) showed positive attitude towards care of the feet. However, there was significant finding on the level of education and the knowledge of foot care (p=0.01);

CONCLUSION:
Strategies should be developed to overcome the longterm complications. As for the Muslim patients, ablution, the ritual practice of washing and cleaning both feet prior to the prayers may be a possible means of checking the feet for any diabetic foot complication.

Matched MeSH terms: Diabetic Foot/etiology*
Risk factor analysis on the healing time and infection rate of diabetic foot ulcers in a referral wound care clinic

Kee KK, Nair HKR, Yuen NP

J Wound Care, 2019 Jan 01;28(Sup1):S4-S13.
PMID: 30724120 DOI: 10.12968/jowc.2019.28.Sup1.S4

OBJECTIVE:: Objectives. To determine the prevalence and risk factors for diabetic foot infection (DFI), and to identify factors associated with delayed wound healing of diabetic foot ulcer (DFU).
METHOD:: The retrospective study was performed in a referral wound care clinic in Hospital Kuala Lumpur. Data was collected from January 2014 to October 2016 on DFU patients who attended this clinic.
RESULTS:: Of the 340 patients (216 male and 124 female) DFU patients who attended the clinic (mean age: 58.1±10.8 years old), 41.5% presented with infection with a mean cross-sectional ulcer area of 21.5±33.2cm2. Binary logistic regression analysis revealed that patients of Chinese ethnicity (OR: 3.39; 95%CI 1.49 to 7.70), with fasting blood glucose ≥7mmol/l (OR: 3.41; 95%CI 1.57 to 7.39), ulcer size ≥10cm2 (OR: 2.90; 95%CI 1.45 to 5.82) and blood pressure ≥140/90mmHg (OR: 2.52; 95%CI 1.54 to 4.14) were more likely to develop DFI. The median healing time for patients with DFUs was three months. There were six variables identified as significantly associated with prolonged healing time of DFU, namely presence of infection (p<0.001), poor glycaemic control with fasting blood glucose ≥7mmol/l (p<0.001), high blood pressure ≥140/90mmHg (p<0.001), large DFU size ≥2cm2 (p<0.001), history of amputation (p<0.005) and plantar location of the DFU (p<0.05).
CONCLUSION:: Large DFU size, poor glycaemic and blood pressure control are common risk factors for both DFU and DFI. Unexpected high prevalence and ethnicity risk factor for DFI urge more comprehensive primary and secondary preventative strategies to reduce its incidence.

Matched MeSH terms: Diabetic Foot/etiology
Fulltext Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems

Yusof NM, Rahman JA, Zulkifly AH, Che-Ahmad A, Khalid KA, Sulong AF, et al.

Singapore Med J, 2015 Nov;56(11):626-31.
PMID: 26668408 DOI: 10.11622/smedj.2015172

Introduction: Diabetes mellitus (DM) is the most common cause of amputations in Malaysia. This study aimed to identify the predictive factors for major lower limb amputation among patients with type 2 DM (T2DM) who were admitted to a hospital, in order to reduce its likelihood.
Methods: This cross-sectional study involved 218 patients with T2DM who were admitted to Hospital Tengku Ampuan Afzan, Kuantan, Malaysia, for diabetic foot problems from June 2011 to July 2012. A form was developed to document the patients' profiles, comorbidities, complications, investigations, treatment and clinical outcomes. The predictors for major lower limb amputations were determined using univariate and stepwise logistic regression analysis.
Results: A total of 31 patients underwent major lower limb amputations (25 transtibial, 6 transfemoral). The following factors were found to be associated with the incidence of major lower limb amputations: T2DM duration ≥ 10 years, diabetic neuropathy, diabetic nephropathy, presentation with gangrene, diabetic foot conditions of Wagner grade 4 or 5, and necrotising fasciitis. Patients who underwent major amputations had significantly lower haemoglobin and albumin levels, and higher total white blood cell counts, erythrocyte sedimentation rates, and C-reactive protein, urea and creatinine levels. However, only T2DM duration ≥ 10 years, positive bacterial culture and albumin levels were significant on stepwise logistic regression analysis.
Conclusion: T2DM duration ≥ 10 years, positive bacterial culture and low albumin levels were found to be significant predictive factors for major lower limb amputation among patients with T2DM admitted for diabetic foot problems.
Keywords: amputation; diabetes mellitus; diabetic foot; lower limb; type II.

Matched MeSH terms: Diabetic Foot/etiology
Fulltext Diabetic retinopathy among type 2 diabetes mellitus patients in Sabah primary health clinics - Addressing the underlying factors

Naserrudin NA, Jeffree MS, Kaur N, Syed Abdul Rahim SS, Ibrahim MY

PLoS One, 2022 01 28;17(1):e0261249.
PMID: 35089931 DOI: 10.1371/journal.pone.0264247

Every person diagnosed with diabetes mellitus (T2DM) is at risk of developing Diabetic retinopathy (DR). Thus, DR is one of the major chronic microvascular complications of T2DM. However, in Malaysia, research about DR is still scarce. This study aimed to determine the prevalence of DR among diabetic patients across 46 primary healthcare clinics in Sabah, Malaysia. Secondly, it purported to identify the factors influencing the development of DR. This cross-sectional study involved a total of 22,345 Type 2 diabetes mellitus (T2DM) patients in the Sabah Diabetic Registry from 2008 to 2015. Of the 22,345 T2DM patients, 13.5% (n = 3,029) of them were diagnosed with DR. Multiple logistic regression revealed seven major risk factors of DR, i.e. patients with diabetic foot ulcer [aOR: 95% CI 3.08 (1.96-4.85)], patients with diabetic nephropathy [aOR: 95% CI 2.47 (2.13-2.86)], hypertension [aOR: 95% CI 1.63 (1.43-1.87)], dyslipidaemia [aOR: 95% CI 1.30 (1.17-1.44)], glycated haemoglobin [(HbA1c) > 6.5 (aOR: 95% CI 1.25 (1.14-1.38)], duration of diabetes mellitus (T2DM) [aOR: 95% CI 1.06 (1.05-1.07)] and age of patient [aOR: 95% CI 1.01 (1.00-1.02)] respectively. DR is a preventable complication. The effective glycaemic control is crucial in preventing DR. In minimizing the prevalence of DR, the healthcare authorities should institute programmes to induce awareness on the management of DR's risk factors among patient and practitioner.

Matched MeSH terms: Diabetic Foot/etiology