Clinical Characteristics and Outcomes of Toe Amputation Among Sudanese Diabetic Patients in Jabir Abu‐Eliz Diabetic Centre at Khartoum, 2021: A Cross Sectional Study

Background Diabetes mellitus (DM) causes a great majority of non‐traumatic major and minor amputations worldwide; up till now, this condition in developing countries, particularly those in sub‐Saharan Africa, including Sudan, is underestimated. Aim To determine the indications and outcomes of toe amputation among T2DM patients. Methods A descriptive cross‐sectional study enrolled 100 patients with T2DM and DFU who had undergone toe amputation at Jabir Abu‐Eliz Diabetic Centre during the period from January to December 2021. Data regarding demographics, clinical characteristics, and outcomes were collected. SPSS v 26.0 software was used to analyze the data. Results Among 100 patients, 63 (63%) were males, and 37 (37%) were females. The mean age was 61.3 ± 12.1 years. Wet gangrene was the main etiology (41%), and most of the cases underwent ray amputation (85%). Complete healing was reported in 65 (65%) patients, re‐ulceration in 17 (17%), re‐amputation in 9 (9%), and mortality in 9 (9%) patients. Re‐ulceration and death were common among the patients with peripheral arterial disease (PAD) ( p value = 0.026) and longer DM duration above 10 years ( p value < 0.001). Moreover, smoking was significantly associated with re‐amputation ( p value = 0.044). Conclusion Toe amputation was associated with males, older, hypertension, oral antidiabetic agents, poor glycemic control, and PAD. The majority of the cases had complete healing. Coexistence of PAD, longer DM duration above 10 years, and smoking were significantly correlated with worse outcomes.