Sixty-second screening for diabetic foot disease: a comparison of two Nigerian teaching hospitals

Abstract

Objectives: This study identified diabetic patients at high risk of diabetic foot disease, using a 60-second screening tool in two Nigerian teaching hospitals. This is important as diabetic foot is the most common reason for diabetic-related hospitalisation and often requires amputation. It is known that patients who undergo any form of amputation are at increased risk of further amputations. However, when patients are diagnosed early and offered adequate care using a multidisciplinary approach, the rate of amputation decreases significantly. Design: This was a cross-sectional study. Consecutively consenting patients with diabetic mellitus who present at both hospitals (University of Ilorin Teaching Hospital and Lautech Teaching Hospital) were recruited into the study. Subjects and setting: The patients had diabetic mellitus and were attending the endocrinology clinic at both hospitals. Sixty-five patients were recruited from the University of Ilorin Teaching Hospital, Ilorin, while 64 patients were recruited from the Lautech Teaching Hospital, Ogbomoso, for the study. Outcome measures: The patients were screened using the 60-second screening tool. This identified patients at high risk of developing diabetic foot who would therefore need further intervention. Results: The study patients were predominantly in the sixth and seventh decade of life (60% at the University of Ilorin Teaching Hospital, and 69% at Lautech Teaching Hospital). Fifteen per cent of patients with a previous ulcer were at the University of Ilorin Teaching Hospital, and 28% at Lautech Teaching Hospital. Deformity was recorded in some patients. Eleven per cent of the patients experienced loss of protective sensation at the University of Ilorin Teaching Hospital, and 30% at Lautech Teaching Hospital. Overall, there was at least one risk factor for 35% of patients at the University of Ilorin Teaching Hospital, and 55% at Lautech Teaching Hospital. Conclusion: Screening for diabetic foot is paramount in reducing the morbidity and mortality associated with the condition. This identifies high-risk patients who require further care. Therefore, efforts should be concentrated on Screening.