Nighat Akbar, Nighat Bilal.
The sweet foot: Relation of glycemic control with diabetic foot lesions.
Int J Pathol Jan ;2(2):91-4.

Introduction: Diabetes mellitus has become an epidemic in the past several decades, owing to the advancing age of the population. The average delay of 4-7 yrs in diagnosing type 2 diabetes mellitus translates into approximately 20% of patients of type 2 diabetes having some evidence of microvascular or neurological diabetic complications at the time of diagnosis. Material & Method: Design: Descriptive observational study. Setting: Out door and indoor patients in P.I.M.S, Islamabad, Pakistan visiting during May to June 7th, 2004 i.e.5 weeks. Patient Selection: All patients with diagnosed diabetes mellitus eligible to be included in the study. Measurements included: 1) Glycosylated Hb. 2) Proteinuria by dipstick. 3) Retinal changes by fundoscopy; 4) Skin lesions 5) Neuropathy such as loss of sensations on self reported history and examination clinically. Results: Out of a total of 36 patients, males were 39% (n=14), females 61% (n=22). Mean age at the time of diagnosis was 42 yrs (15 yrs - 56yrs); mean age at presentation to us was 53 yrs (25-69 yrs); mean duration of diabetes was 15 yrs (I month - 5yrs). Of these patients 94% (n=34) were taking some form of treatment which included oral hypoglycemics in 94% (n=32) and oral and parentral drugs i.e. insulin in 6% (n=2). Of those taking treatment 56% (n=20) had controlled diabetes mellitus (DM) while 44% (n=16) were having uncontrolled DM at presentation. Mean value of glycosylated haemoglobin (Hb) was 8.2% (6-16.6%). Conclusion: Incidence of diabetes foot lesion strongly correlates with poor glycemic control which is in itself best manifested by levels of glycoslated haemoglobin.

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