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RESEARCH ARTICLE

SA JOURNAL OF DIABETES & VASCULAR DISEASE

14

VOLUME 17 NUMBER 1 • JULY 2020

Our study showed that increasing height of patients was

associated with increased risk of diabetic foot. This finding agrees

with that of Sosenko

et al

.

,

38

who also found patient’s height to

be associated with diabetic foot. This may be related to increased

demyelination in tall patients compared to shorter individuals,

with shorter limb nerve fibres. Our study did not find duration of

diabetes to be associated with diabetic foot ulceration, which is

similar to other studies.

39,40

The strength of this study was in using many screening

instruments for the assessment of DPN. However, the study was

limited because the screening instruments could not be compared

with a more objective instrument for the diagnosis of DPN, such

as nerve-conduction studies or VPT. Hence, the sensitivity and

specificity of these screening instruments could not be established.

Conclusion

The aim of this study was to determine risk factors for diabetic

foot ulcers among Nigerians. Health practitioners should extend

beyond just treating the ulcers; attempts should be taken among

diabetics to prevent ulcers in the first place. Screening to identify

factors that could accurately predict those who are at risk of foot

ulceration is practical in an out-patient setting in a low-resource

country. Early identification of these factors, especially diabetic

neuropathy, will prevent ulcers forming in patients with diabetes

in this environment. Detection of these factors using a simple, less-

expensive, easily available and less time-consuming tool could help

reduce the incidence of diabetic foot ulcers.

These screenings and foot examinations may even be carried

out by nurses and other health practitioners after minimal training.

This is important because of a dearth across Nigeria (as in other

parts of the world) of diabetes and foot-care specialists (podiatrists)

who are key members of the diabetes team. The findings in this

study will therefore be helpful in clinical practice to identify diabetic

patients prone to developing diabetic foot. The establishment of

specialised diabetic foot clinics to address foot problems in our

environment and the combination of related health professionals

(diabetologists, plastic surgeons, orthopaedic surgeons, diabetes

nurses, dieticians and physiotherapists) in the management and

preventions of diabetic foot problems will assist in early diagnosis

and also reduce the prevalence of foot complications.

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