[Podological risk in patients suffering with diabetes in a Bamako health center]

To identify risk factors for foot joint pathologies in diabetic patients at the District I Bamako health center (CSref I).

This was a prospective descriptive study from October 2009 to March 2010 at CSref I. The sampling was complete after interrogation, physical and para-clinical examination data were collected and analyzed. The statistical test used was the chi 2 with a significance level p ≤ 0.05.

Among the 232 diabetic patients' collected data, female predominance was clear: sex ratio 0.36 with a mean age of 53.03 ± 11.75 years. Physically 58.20% of patients were overweight or obese with diabetes lasting for 5 years in 65.5%. Diabetes was type 2 in 96.1% of cases. The foot lesions were discoverable mode of diabetes in 12.1%. 65.9% of patients were aware of proper foot hygiene procedures but more than half do not practice sufficient hygiene 59.1%. During the study, among the direct risk factors, peripheral sensory neuropathy was more common in the 67.7% and was correlated with patient age (p=0.001), with the duration of the evolution diabetes (p=0.005), with the existence of dyslipidemia (p=0.003) and with poor glycemic balance (p=0.002). Foot deformity existed in 11.6% and type of flat foot, d-hammer toes and Charcot foot. 15.1% of patients had arterial disease that were significantly correlated with the age of patients (p=0.007), disease duration of diabetes (p=0.002), poor glycemic control (p=0.001). Poor venous state exists in 10.34% followed by smoking and alcoholism, respectively 3.88% and 1.29%. Among the foot lesions found, cracks were in 1st place with 22.84% associated or not with other lesions. 1.29% of patients had gangrene. 29.70% of patients had a risk of foot problems in grade 0 70.30% to 10.80% in grade 1 and grade 3 in 9.10%.

Our diabetic patients had grade 0 in two thirds of cases. The implementation of a program of prevention and early treatment of diabetic foot will often decreased podiatric source of disability risk.