Volume 1 number 1 Summer 2003
Special issue for the abstracts of the 7th Pan Arab Conference on Diabetes
PACD7 , 25 – 28 March 2003 Cairo

Abstract Number : 13
LEADING CAUSES OF FOOT ULCERATION AND AMPUTATION AMONG THE PATIENTS IN UZBEKISTAN

Abstract:
Kamalov TT, Dosova ZKh, Rakhimdjanov A, Kuziev ShK, Shamansurova ZM. Institute of Endocrinology, Kh.Abdullaev Street 56, Tashkent 700143, and UZBEKISTAN Background and aim. One of the major social problems among of Diabetic complications is Diabetic foot, which involve increasing of expenses for care. Cases of foot damage may be different according to life style and habitation. Identification of the major cases of foot ulceration and amputation are important in future preventing actions among the patients in the region. Material and Methods. 181 patient’s data which were cured at the Diabetic Foot Department at the Institute of Endocrinology in UZBEKISTAN with chirurgic problem were analysis.

Results:
Duration of disease was 11.3 years in type 1 DM and 6.7 at the type 2-DM. With type 1 DM were 15% and other 85% patients were with type 2 DM, 47.5% female and 52.5% male among them. 77% of all foot problems were undergoing to amputation. Surprisingly that 50% of ulcers were localized on right and 50% on the left leg, 25% of patients had amputations in past. Diabetic nephropathy presented in 93% patients but Uremia was detected in 2% of all cases. Diabetic retinopathy was detected in all 100% patients, where prolipherative DR consist in 13.6%. At the Foot Department 93% of patients were treated with insulin, 4.5% in combination insulin with antidiabetic drugs. 4.5% only with drug and 1% with diet. In 36% patients had reccurence ulceration and amputation in future. Frequency cause of diabetic foot was burning of feet after heating by water heater (50%), in second foot ulcer come after cessation or decreasing of dosage of insulin injection (19%), in third - after footwear problem (15%). Diabetic self-control in single causes consist only blood glucose control by glucometr without control of diet, calory intake, weight control, microalbuminuria and blood pressure not been checked before in 79%. 

Conclusion:
The major causes of the diabetic foot ulceration are burning after water heater, which equally may find in both left and right leg and not depended from sex, but depended from disease duration, presence of other diabetic complications, history of amputation and need in more education in manifestation of disease. 

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