Clinical Outcome & Determinants of Amputation in Diabetic Patients in Al-Wahda Hospital

Abstract

Diabetes mellitus is a metabolic endocrine disorder due to an overall deficiency of insulin (Type 1) or defective insulin function (Type 2), which causes hyperglycemia. Type 1 diabetes, which is usually seen in younger patients, accounts for 5% to 10% of cases worldwide and is secondary to the autoimmune destruction of insulin-producing B-islet cells of the pancreas, which results in complete insulin deficiency. Diabetic foot ulcers (DFUs) represent a major health challenge and are among the most serious and costly complications of diabetes mellitus. This study determined the predictive factors of diabetes foot ulcer (DFU) development and lower extremity amputations (LEA) in patients with diabetes mellitus (DM), which is of great importance to compose risk stratification models. The retrospective cohort study that included (n= 50) diabetic patients admitted to the surgical department at al-wahda hospital conducted for a period of seven months. The data were collected from the medical records, including age, duration of diabetic disease, foot ulcer (duration, site, investigation, and treatment), and operative notes from the operation records of the surgical department. A total of 50 diabetic patients had a diabetic foot ulcer and underwent major or minor amputation according to the indication. All collected data were entered and analyzed using the Statistical Package for the Social Sciences version 26. Descriptive statistics were used to summarize participants’ characteristics. Categorical variables were presented as frequencies and percentages, while continuous variables were summarized using mean and standard deviation. Additionally, inferential analyses such as Chi-square tests and Kappa statistics were performed as appropriate to examine associations and inter-rater reliability. The majority were female (36 participants, 66.7%), and 14 participants were male (25.9%). The mean age of participants was 60.8 ± 13.25 years, indicating that most participants were middle-aged to older adults. Type 2 diabetes was the predominant form, observed in 45 participants (83.3%), while type 1 diabetes was less common (5 participants, 9.3%). There were 4 participants (7.4%) with unspecified diabetes type. Infected ulcers were reported in 4 participants (7.4%), with unspecified gender. Ischemic ulcers in the distal part of the foot were more common in females (12 cases, 22.2%) than in males (4 cases, 7.4%). Neuropathic ulcers in the sole occurred in 10 female cases (18.5%) and 4 male cases (7.4%). In our research, If the patients had controlled diabetes mellitus with regular diabetic foot care, they would have responded to treatment avoidance of amputation.