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  • Title: The prevalence of neuropathic foot ulceration in Sri Lankan diabetic patients.
    Author: Fernando DJ.
    Journal: Ceylon Med J; 1996 Sep; 41(3):96-8. PubMed ID: 8917968.
    Abstract:
    OBJECTIVE: To determine the prevalence of diabetic neuropathy and neuropathic ulceration among patients with non-insulin dependent diabetes (NIDDM) attending a Sri Lankan diabetic clinic. SETTING: The diabetic clinic of the General Hospital Colombo (Sri Lanka National Hospital). RESEARCH DESIGN AND METHOD: Five hundred randomly selected diabetic patients (mean age 47.4 SD 17.59 years, 275 were males, mean duration of diabetes 5.29, SD 6.44 years) were screened for diabetic neuropathy using a neuropathy symptom score (NSS) neurological disability score (NDS) and pressure preception threshold using Semmes Weinstein monofilaments. RESULTS: Patients with neuropathy were older (mean 55.69 years SD 14.16) than those who did not (mean 47.1 years, SD 15.05 p = 0.001) and had diabetes for a longer period (mean 7.5, SD 8 years vs 4.8 SD 5.66, p = 0.002). 123 (30.6%, 95% CI 28-32%) patients had neuropathy according to the criteria used. 51(10.2%, 95% CI 8.2-12.2%) had a foot ulcer, a history of foot ulceration or a lower extremity amputation due to neuropathic ulceration. 26(5.1%, 95% CI 3.2-7%) patients had neuropathic foot ulcers at presentation and a further 14 (2.8%, 95% CI 1.4-4.2%) had developed an ulcer within one year of diagnosis of diabetes. 24 (4.8%, 95% CI 3-6.8%) had a history of lower extremity amputation. CONCLUSION: Neuropathic ulceration is a significant cause of morbidity in patients with NIDDM. One third of all NIDDM patients attending the clinic had a risk of foot ulceration. Preventive foot care programmes should be implemented at all diabetic clinics in Sri Lanka.
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