Publication:

Diabetic foot: vasculopathy assessment and analysis of risk factors of amputation

Background Diabetes is a major contributing factor in up to 70% of lower limb amputations. In majority of diabetic patients, the underlying factor contributing to eventual amputation is diabetic foot disease and diabetic foot ulcer. The burden of diabetic foot disease and ulceration is set to increase further due to the co-existence of contributory co morbidities including peripheral vascular disease and peripheral neuropathy.

Methods An observational study was designed to assess the vascular status of diabetic foot patients and the risk factors of lower limb amputation.

Results Diabetic foot ulcers was recorded mostly among males and found to increase with age. Smoking was noted in 87% of the male patients who had diabetic foot ulcers. Gangrene was the major and most common mode of presentation in diabetic foot ulcer patients. The angiopathy should be considered as the major risk factor which leads to major limb amputation, which can be easily detected at the earliest stage by simple clinical examination of peripheral pulses and by arterial Doppler study which is non-invasive.

Conclusion Present study was carried out to assess the vascular status of diabetic foot patients and to assess the prevalence of risk factors due to the lower limb amputation like Ray amputation, below knee amputation, wound debridement. Arterial Doppler, radiography, fundoscopy and neuropathy were done. Based on a study of these results, it was found that vascular status plays a major role in majority of the diabetic patients. Thus, angiopathy in diabetics must be taken into serious considerations and it is suggested that arterial Doppler can be done as a part of clinical examination to combat the major limb amputations.