22 S Diabetic Foot In Primary Health Care: A Community Based Study.

Conference: 
Author(s): 
Gimbert RM, Tomcis P, Llussa J, Mendez A., Mundet X., Hernandez E., Cano JF and the GedapS Group Catalan Family and Community Medicine Society. Barcelona (Spain)
Text: 
Objectives:
To assess prevalence of diabetic foot in Non-Insulin-Dependent Diabetes Mellitus (NIDDM) in Primary Health Care and to analyse its relationship with clinico-biological variables.
Patients and Methods:
Crossover study carried out during 1993-94 in 76 PHC Centres, attending 1.256.193 adults. 2.595 NIDDM were selected by systematic sampling from 31.050-registered NIDDM. Each patient contributed once (either with an ulcer/lesion or amputation) to this study. Means were compared by the T-Student test and percentages by X2_test.
Results: Diabetic foot was reported in 260 of the 2595 patients (10%, Cl 95%: 8.85-11.15). Fifty-five patients (2.1%, Cl: 1.55-2.65) had undergone amputation in any moment of his life. During the study 205 patients reported ulcers/lesions (7.1%, Cl : 6.86-8.94). We found significant differences in the mean age (4.53 years higher in the Diabetic Foot Group (DFG), Cl 3.32-5.74), average diabetes evolution (2.75 years longer in DFG , Cl: 1.64-3.87), microvascular complications (32. 1% higher in DFG, CI:24.6-39.6), macrovascular disease (15.9 % higher in DFG Cl, 9.6-22.2) and current level of HbA1c (0. 55 % higher in DFG, Cl 0.22-0.87).The number of current smokers was higher in DFG (5.1%, Cl: 0.7-9.5), specially in men older than fifty (9.7%, Cl: 0.3-19. 1).
Conclusions:
Diabetic foot is close related with long standing diabetes (>10 years), poor glycaemic control and presence of any kind of micro/macrovascular complications. Our data suggest the need to carry out specific interventions on foot care in all patients with more than 10 years of diabetes evolution.
Literature: 
22 S DIABETIC FOOT IN PRIMARY HEALTH CARE: A COMMUNITY BASED STUDY.