Abstract:
OBJECTIVE:To determine whether intensive treatment and education strategies for type 2 diabetic patients with high-risk diabetic foot disease helps in preventing foot amputations. RESEARCH DESIGN AND METHODS:Participants included 4,872 consecutive type 2 diabetic patients (male-to-female ratio 3,422:1,450, mean (+/-SD) age 60.5 +/- 8.8 years, mean duration of diabetes 13.7 +/- 7.6 years) with high-risk diabetic foot disease. The patients were categorized as high-risk subjects according to the International Consensus on the Diabetic Foot. The three study groups were subjects with diabetes and neuropathy (group 1; n = 2,871), diabetic neuropathy with deformity (group 2; n = 235), and diabetic neuropathy with deformity and foot ulceration or peripheral vascular disease (group 3; n = 1,766). Neuropathy was diagnosed by biothesiometry. Peripheral vascular disease was diagnosed as an ankle brachial index <0.8. All the subjects were educated regarding diabetic foot disease and its complications and prevention. They were also instructed to visit the center if any sign of new lesions appeared. RESULTS:Among the 1,259 group 3 subjects who came for follow-up, 718 (57%) strictly followed the advice given and 541 (43%) did not. Ulcers present during the recruitment had healed in 585 (82%) subjects who followed the advice, but in only 269 (50%) subjects who did not. A significantly larger proportion of subjects who did not follow the advice developed new problems (26%) and required surgical procedures (14%) compared with those who followed the advice (5 and 3%, respectively). CONCLUSIONS:Strategies such as intensive management and foot care education are helpful in preventing newer problems and surgery in diabetic foot disease.
journal_name
Diabetes Carejournal_title
Diabetes careauthors
Viswanathan V,Madhavan S,Rajasekar S,Chamukuttan S,Ambady Rdoi
10.2337/diacare.28.5.1019subject
Has Abstractpub_date
2005-05-01 00:00:00pages
1019-21issue
5eissn
0149-5992issn
1935-5548pii
28/5/1019journal_volume
28pub_type
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