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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