The influence of peripheral neuropathy and peripheral vascular disease in the outcome of diabetic foot management – a prospective study

Peripheral neuropathy and Peripheral Vascular Disease are the risk factors for the development of diabetic foot. The aim of this study was to evaluate differences and predictors of outcome parameters in patients with diabetic foot by stratifying these subjects according to the severity of these risk factors. This is a prospective study conducted in 70 patients in the age group of 30–90 years diagnosed as Type II Diabetes with foot ulcers. After detailed clinical examination the following tests were conducted in all the patients: Complete blood count (CBC), Haemoglobin (Hb), Random Blood Sugar (RBS), Erythrocyte Sedimentation rate (ESR), Chest X-ray(CXR), Electrocardiography (ECG), foot X-ray, pus culture, Neuropathy testing by Semmes Weinstein Monofilament Test and Vibration Perception Threshold and Peripheral vascularity assessment by Duplex Doppler. Then grading of the ulcers was done using Wagner's Grade. The outcome of the patients was assessed by recording the healing time, mode of surgery and amputation rates of the patients. A total of 70 patients with diabetic foot were consecutively included into the study (65.7% male, age (31% in 51–60 years), mean diabetes duration (5.2 years), Ulcer Grade (37% in Grade IV), Foot lesions (45.7% in toe), Blood sugar levels (64% in 300–400 mg/dl), Neuropathy (84%), Peripheral vascular disease (67%), major amputation (7%) and mortality (1.4%). All diabetic patients should undergo testing for neuropathy and peripheral vascular disease apart from doing other tests.