The pattern of presentation of foot lesions in Nigerian diabetic patients

Abstract

Foot lesions constitute an important cause of morbidity and mortality in Nigerian diabetics, yet remain poorly characterised. We, therefore, prospectively studied 50 diabetics with 84 major foot lesions over a three-year period at Ibadan, Nigeria. Sixty eight percent of the patients were illiterate and 80% ignorant regarding the importance of footcare. Duration of diabetes was significantly longer in these patients (p less than 0.05) than in age- and sex-matched diabetics without foot lesions. The prevalence rates of neuropathy (68%), foot ischaemia (54%), hypertension (42%) and nephropathy (20%) in diabetics with foot lesions were higher than in previous reported groups of Nigerian diabetics. The initiating factors were predominantly trivial trauma and "spontaneous" blisters. Sixty percent were anaemic at presentation, while short-term glycaemic control was generally poor. Mixed bacterial organisms were cultured in 70% of the cases, with anaerobes presumed present in 33%. Chronic osteomyelitis (38%) and soft tissue changes (35%) were the commonest foot x-ray findings. Some aspects of prevention of foot lesions were discussed.