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Year : 2003  |  Volume : 3  |  Issue : 2  |  Page : 12-15

Determinants of Foot Ulceration in Nigerian Diabetic Patients A Review of Risk Factors

1 Department of Medicine, Lagos State University Teaching Hospital, Ikeja
2 Department of Medicine, College of Medicine, Idi-araba

Correspondence Address:
A O Ogbera
Department of Medicine, Lagos State University Teaching Hospital, Ikeja

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Source of Support: None, Conflict of Interest: None

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Background and Objectives: Diabetes mellitus foot syndrome (DMFS) is an important cause of morbidity and mortality in Nigerian diabetics. Identification of the risk factors for foot ulceration is of paramount significance in the prevention of this all important complication of diabetes mellitus. As such, this study sets out to determine the risk factors of DMFS, of which the results are hoped to be of practical usefulness to care givers, policy makers and as well as to people living with diabetes mellitus. Subjects and Methods: This study was carried out in the Lagos University Teaching Hospital (LUTH) over a one year period. It is a case-control study in which 47 diabetic patients with past or present foot ulceration were studied. An equal number of controls who were diabetic patients with no past/present history of ulceration were studied. Relevant medical history, general physical examination neurological, vascular, ocular, metabolic and other assessments were carried out in these two groups of patients. Data were analyzed using the statistical package for social sciences SPSS version 9. The test statistic used included Student's t test, Chi squared test and logistic regression for the determination of odds ratio. Results: The risk factors that were strongly associated with foot ulceration included peripheral vascular disease, male sex, nephropathy, retinopathy, foot deformities, history of previous foot ulceration or amputation, cataract formation, poor glycaemic control, neuropathy and Tinea pedis. Weakly associated risk factors for foot ulceration were walking unshod, being of a low socio-educational status and smoking. Conclusions: The risk factors for foot ulceration are potentially preventable. As part of a comprehensive foot care program, education on foot care should be directed at the patients, family members of the patients as well as the health care providers.

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