Prevention activities and risk factors in diabetes mellitus and diabetic foot

Abstract

Objectives: to determine prevalence and prevention activities by physicians and patients. Identify risk factors: foot, metabolic, dietary and nutritional status.

Methods: a descriptive, cross-sectional study, from October 2009 to June 2011 in adult patients hospitalized with diabetes mellitus. Ethics Committee approval. Medical questionnaire, nutritional assessment, measurement A1c and lipids, education through self care booklet.

Descriptive analysis: quantitative and qualitative variables, Pearson correlation coefficients; Excel 2007 and SPSS version-15.0 programs.

Results: 263 patients were surveyed; 44.1% men and 55.9% women; mean age 63.6 ± 13.3; time of diabetes diagnosis 11.4 ± 8.5 years. 58.9% had primary schooling, socioeconomic status 1-2 (71.3%).

Clinical antecedents: ulcers 14.8%, 1.9% amputation, dysesthesias 49.8%, 22.7% intermittent claudication, foot exam by physician 42.9%.

Prevention activities by doctors are precarious because 59.5% do not educate about foot self-care, 57.1% examine feet, 68.3% ask about dysesthesias, 74.8% about intermittent claudication. Inadequate daily feet self-care by patients because they don`t inspect their feet 27.4% or the inner shoes 28.1%; 8% do not make interdigital drying; 58.8% do not lubricate their feet; 63.2% make no self-monitoring; 68.1% have inadequate nail cutting; 21.7% do not use stockings, 98.5% do not have therapeutic footwear; 55.1% have no family collaboration.

Metabolic dyscontrol: A1c 9.6 ± 2.7%; LDL-C 99.1% ± 31.3 mg; triglycerides: 171.9 ± 97.9 mg%. 39.4% do not have nutritionist counseling; 58.9% present pre-obesity-obesity. Correlation: BMI and waist midpoint circumference (r = 0.750, p = 0.000); BMI and body fat percentage (r = 0.586, p = 0.000). Eating habits: fried food preference 42.3%; Low consumption: animal protein (12.7%), dairy (31.8%), fruits (64.7%) and vegetables (57.9%); high starch consumption (43.4%).

Conclusions: prevention efforts by doctors and patients are deficient. Risk factors for diabetes mellitus and diabetic foot observed were: hyperlipidemia, hyperglycemia, obesity and inadequate eating habits