Incidence and risk factors for developing diabetic foot ulcerations (+risk of Osteomyelitis) in geriatric patients. Relationship between depression, social isolation, and cognitive impairment with DFU
1 Amin, U.,2 Kuminev, C., 1 Madden, E., 1 Doyle, C., 2 Barrett, S., 1 McHugh, C.
1-Sligo University Hospital, The Mall, Sligo. 2-Sligo Institute of Technology, Ash Lane, Sligo
Diabetic foot ulceration (DFU) is a well known complication of longstanding poorly controlled diabetes mellitus occurring in 6.3% of people with diabetes. Longstanding suboptimal diabetes control leads to the development of peripheral sensory neuropathy, and requires intensive self care to avoid subsequent ulceration and risk of possible Osteomyelitis.
The hypothesis of this study is that people with depression, cognitive impairment and social isolation self-care less well. The aim of this study is to determine the prevalence of depression, cognitive impairment and social isolation in people with DFU compared to those with peripheral neuropathy but no ulceration
This was an observational study conducted in Sligo University Hospital (SUH), Sligo, Ireland. Participants completed a paper based questionnaire including social demographic data, medical history, mini-mental test and depression score. All subjects were assessed by monofilament testing for peripheral neuropathy.
52 subjects with peripheral neuropathy were included in the study: 26 with foot ulceration, 26 without ulceration. The study found no significant correlation between DFU and depression, or duration of diabetes. Those with neuropathy but no ulceration were more likely to have a normal hba1c as a marker of good diabetes control. There was significant correlation between male gender and DFU, age of the youngest member in the house, amputation, retinopathy, and degree of neuropathy. There was no significant relationship between DFU and smoking, alcohol, living in a rural area, living alone, type of care, home help, public health nurse visit, attending a day hospital, leaving the house frequency, member of social clubs, driving, diabetic control or PAD.
In our study no relationship between depression and DFU was found. This finding is not consistent with the previous studies on similar comparison.Significant relation between DFU and male gender was noted. Although in our study the duration of disease is not significantly associated with DFU but it was found that normal values of HbA1c were associated with less incidence of DFU.