Factors Associated with Diabetic Foot Ulcers in Benin – City, Nigeria

Abstract

Background and Objectives: Diabetic foot ulcers (DFU) are the most common causes of prolonged hospitalization (associated with considerable economic costs) in persons with diabetes mellitus (DM). In resource-poor countries such as Nigeria, it becomes necessary to identify the risk/precipitating factors of DFU in order to institute the appropriate locale-specific and relevant preventive measures, hence this report.
Subjects and Methods: A prospective study of all DM persons with DFU admitted in the University of Benin Teaching Hospital, Benin City, Nigeria over a 3-year period, was carried out. Sociodemographic and clinical data were obtained from all subjects. Information on the type and duration of DM, medical comorbidities, risk and precipitating factors of DFU and casual
plasma glucose (CPG) levels on admission were documented.
Results: Thirty (61%) of the 49 eligible persons seen during this period were males. Type 2 DM was diagnosed in 37 (75.5%) persons. The mean age was 56.5 (12.9) years and mean DM duration was 8.9 (6.0) years. Twelve (24.5%) persons had hypertension, 6 (12.2%) persons had visual impairment; peripheral neuropathy and vascular disease were present in 13 (26.5%) and 3 (6.1%) persons respectively. The most commonly
reported precipitating factors of DFU were puncture wounds (20.4%) and burns/scalds (14.3%); 23 (47%) persons reported no obvious precipitating factor(s). The most commonly identified risk factors for DFU were improper foot-care (38.8%) and peripheral neuropathy (26.5%). The mean CPG level on admission was 11.6 (8.0) mmol/L. A significant proportion of subjects were policemen/teachers/clergymen and farmers (X2 = 16.9, p < 0.02).
Conclusion: Our study shows that poor DM control, male gender, improper foot-care, peripheral neuropathy and occupations which may involve prolonged standing are important factors in the development of DFU in this locale. We recommend that examination of the feet and attainment of optimal glycaemic control should be intensified by all DM care – givers,
as early detection and management of identified risk factors ultimately reduces DM morbidity of mortality.

Niger Med J. Vol. 49, No. 1, Jan. – Mar., 2008: 9 – 11.

Keywords: Diabetic foot ulcer, foot-care, Diabetes mellitus morbidity, mortality.