AN APPROACH TO DIAGNOSIS AND MANAGEMENT OF DIABETIC FOOT

Abstract

INTRODUCTION India has the dubious distinction of becoming the diabetic capital of the world within the next few years; with its attendant\ncomplications it is going to burden the resources of the country. In the past, the diabetics succumbed to the metabolic complications like\nketoacidosis, but now they survive long enough to develop and succumb to the diabetic nephropathy and diabetic foot complications.\nAIMS AND OBJECTIVES The various predisposing factors for diabetic foot with respect to North Bihar population. To analyse the different\nways of clinical presentation of diabetic foot in our hospital. To evaluate the usefulness of surgical management available with special emphasis on\nstrict glycemic control. To determine commonest microorganism/s infecting the diabetic foot patients in the North Bihar Population.\nMATERIALS AND METHODS Department of General Surgery, DARBHANGA MEDICAL COLLEGE AND HOSPITAL,\nLAHERIASARAI.\nDiabetic patients with foot ulcers admitted in this hospital, according to the WHO criteria, were selected for this study for 1 Year 8 month (April\n2019 to December 2020).\nRESULTS AND ANALYSIS We found peripheral Pulse of 37.9% of the patients was absent. Infection was present in 86.2% of the cases which\nwas signi\uf001cantly higher (Z=10.23;p<0.0001). Ulcers were mostly at dorsum (22.4%) (Z=1.58;p=0.11) followed by fore foot (13.8%) and great toe\n(13.8%). Ulcers were mostly right sided (67.2%) followed by left sided (31.0%) (Z=5.12;p<0.001). Only 1(1.7%) patients had bilateral infection.\nCONCLUSION The prevalence of risk factors for foot ulcer and infections, viz., neuropathy and vasculopathy, are different from the Western\nliterature. Studies from India, suggest predominantly neuropathic ulcers unlike the West where neuroischemia is the most important predisposing\nfactor.As compared to the West, which have predominant Gram-positive infections, centers throughout India have reported a consistent Gramnegative bacterial preponderance in DFI.