Undiagnosed and Untreated Peripheral Complications of Diabetes: Findings from a Pilot Study on Diabetes-Related Foot Diseases (DFD) in Patients with Glycemic Disorders

Background:Diabetes-related foot disease (DFD) is a serious complication of diabetes, increasing the risk of amputation.Coimplications are preventable, but most diabetics do not receive proper screening and treatment, despite indications.This study was a pilot screening of diabetes-related foot disease in a group of people with glycemic disorders. Material/Methods:We recruited 143 volunteers over 40 years of age.In the final analysis, we included 85 people diagnosed with glycemic disorders (diabetes or prediabetes), for whom we performed a total of 170 foot measurements.We screened for peripheral artery disease using: foot pulse, ankle-brachial index (manual and automatic), toe-brachial index, and transcutaneous oxygen pressure (TcPO2).To screen for diabetic peripheral neuropathy, we used indicators of loss of protective sensation: pressure perception and temperature perception, and plantar pressure distribution. Results:A history of diabetes was reported by 26 (30.6%) of the subjects.Disorders of at least 1 foot occurred in 20 (66.7%) subjects with diagnosed diabetes and in 10 (17%) subjects declaring no diabetes.Higher risk and DFD category were correlated with duration of diabetes (r=0.68,p=0.007), glycemic levels (r=0.56,p=0.001), age (r=0.57,p=0.007), and the presence of other diabetes complications.The best predictor of risk in DFD was manual ABI, p=0.001; followed by automatic ABI, p=0.006. Conclusions:Our results showed that peripheral complications of diabetes, such as DFD, often remain undiagnosed and untreated despite the high risk of developing ulcers.There is a need for multi-center screening studies.