Amputations After Diabetic Foot Infections- the Cost of Neglect

Abstract

Diabetic foot infections are the major cause of morbidity and mortality in patients with diabetes mellitus. Most of the infections are treatable even if not preventable. The purpose of this study was to highlight the Problems associated with diabetic foot infection and to evaluate their outcome. This prospective observational studs’ was carried out at Mayo hospital Lahore for period of two years started form July 2000. All the patients with diabetic foot ulceration/infection were included. Glycemic control was achieved with insulin. Primary amputations were done depending upon the condition of the limb and the status of infection and that of the patient. A total of 207 patients presented with Diabetic Foot ulceration in 2 years. Most of the patients were in their fifth and sixth decade of life with male to female ratio of 2.5:1, among which 84% (n=174) patient had NIDDM while 16% (n=33) had IDDM. Most of the patients (n=149) 72% were with poorly controlled DM. A total of 152 (73%) amputation were performed with 60% (n=123) primary amputation and 13% (n=29) secondary amputation. The cost spend on the treatment of per patient per day was 800 Rs (14 US$) with a average total cost of 15000 Rs (255 US$) per patient per treatment to a total cost of 3105000 Rs (52629 US$) in two years. Diabetic foot infection ¡s a treatable disease if not preventable that can be done by providing patient education, early diagnosis, early referral and prompt treatment at all levels of health providing agencies.