[A program for screening patients at a high risk for lower extremity ulcers and amputations]

Area of Science:

• Podiatry
• Endocrinology
• Public Health

Context:

• Diabetes mellitus (DM) poses a significant risk for lower extremity complications, including trophic foot ulcers and amputation.
• A long-term screening program in Saint Petersburg has evaluated patients at high risk for these complications since 2001.

Purpose:

• To analyze the results of a comprehensive screening of diabetic patients at high risk for foot ulcers and amputation.
• To identify prevalent risk factors and assess the risk stratification of the screened population.

Summary:

• 3807 patients with DM (96% type 2) were screened, with a mean age of 66.5 years and DM history of 9.6 years.
• 43.1% low risk, 37.3% intermediate risk, 14.6% high risk, and 5% very high risk.
• Foot deformity (46%), severe polyneuropathy (11.5%), and lower extremity angiopathy (10.6%) were key findings, with deformities more common in type 1 DM.

Impact:

• Nearly 20% of patients were categorized at high or very high risk, underscoring the need for dedicated Diabetic Foot care centers.
• Foot and toe deformities emerged as the most frequent risk factors, influenced by the aging population.
• The findings advocate for establishing additional Diabetic Foot rooms focused on patient care and reviewing orthopedic provisions for diabetic patients due to the high prevalence of foot deformities.