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  • Title: Studying the Diabetic Foot at Risk Using a 60-Second Foot Screening Tool and the Importance of the Categories of the Foot at Risk in Diabetes Patients at a Tertiary Care Center in East India.
    Author: Behera KK, Soren UK, Behera BK, Devi S.
    Journal: Cureus; 2024 Oct; 16(10):e72615. PubMed ID: 39610618.
    Abstract:
    Introduction The etiology of a diabetic foot ulcer (DFU) is multifactorial. The three main components that are implicated in DFUs are foot deformity, repeated minor trauma to the foot, and diabetic peripheral neuropathy.  Aim and objectives The study aims to find the prevalence of diabetes patients having a foot at risk using the Simplified 60-Second Diabetic Foot Screen tool (SSDFST). The objective is to ascertain the dispersal of various categories of the foot at risk in patients with diabetes and to find out the association of neuropathy with the various risk factors for the evolution of DFUs. Materials and methods This was a cross-sectional study comprising 128 patients; a detailed history and examination including neurological and vascular assessment were performed attending a tertiary care hospital. Patients were screened for the risk of diabetic foot using the SSDFST. The detection of loss of protective sensation (LOPS) using a simple 10-g monofilament test (10g M) was highly predictive of subsequent ulceration, which had been reported by the Seattle Diabetic Foot Study. The foot at risk was correlated with demographic and clinical features. Data were analyzed using descriptive and inferential statistics, significant at p = 0.05. Results Out of 128 patients, 92 (72%) and 36 (28%) were male and female, respectively. The mean duration of diabetes was 7.42 ± 6.23 years (range 1-27). The mean age and BMI of the study population were 53.13 ± 10.99 years and 25.93 ± 4.46 kg/m2, respectively. Out of 128 patients, 82 (64%) were normal without any risk factor for diabetic foot, and 46 (36%) patients had at least one risk factor for diabetic foot using the SSDFST. About 36% of patients were combinedly qualified for the foot at risk into (categories 1, 2, and 3), among which six (5%) were placed under category 1, 18 (14%) patients were classified under category 2 with LOPS + PAD, and 22 (17%) were placed under category 3 with a history of ulcer and/or amputation. The duration of diabetes, previous foot ulcer, deformity, absent pedal pulses, active ulcers, and neuropathy (p = 0.05) were significantly associated with neuropathy measured by 10g M.  Conclusions Our study revealed that one-third of our patients had at least one risk factor for the diabetic foot using the SSDFST. About one-fifth of our patients had neuropathy detected by monofilaments. Meanwhile, two-fifth of the study population were aware of proper foot care practices.
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