A Descriptive Study Of Foot Complications In Diabetic Patients With Symptomatic Peripheral Neuropathy

Abstract

Background Symptomatic peripheral neuropathy in a diabetic patient may be associated with the presence of other foot complications, which may otherwise be overlooked. Objective We conducted this study to determine the prevalence of symptomatic peripheral neuropathy among diabetic patients attending the diabetes outpatient clinic of our hospital as well as document the presence of other foot complications/problems in patients with symptomatic peripheral neuropathy. Methods A cross-sectional survey of foot complications was conducted over a 6-month period in diabetic patients symptomatic for peripheral neuropathy and compared with age/sex matched diabetics without peripheral neuropathy and apparently healthy individuals. Results Of 322 diabetic patients studied, 64(19%) had symptomatic peripheral neuropathy. The most frequent symptoms of peripheral neuropathy were numbness or tingling sensation in (65.6%), cramps, aches and fatigue (14.1%) respectively, and burning sensation (10.9%). Dry skin, hyperpigmentation, corns and callosities, cracked skin and fungal infections were the most frequent lesions seen in diabetic patients symptomatic for peripheral neuropathy. These lesions occurred more frequently in them than in patients without neuropathy and healthy subjects. While (34.7%) symptomatic patients had foot ulcers, none was recorded in the asymptomatic or healthy population. Conclusion Foot complications other than foot ulcers may occur in diabetic patients with symptomatic peripheral neuropathy. Awareness of these skin and foot lesions and their sequelae with prompt initiation of measures to limit disability may prevent limb losses/foot deformities and should be emphasised. Proper education on foot care and frequent limb inspection can never be over emphasised. Moreover, these foot lesions may also serve as markers for the presence as well as severity of peripheral neuropathy. Introduction Les neuropathies diabetiques symptomatiques s\'accompagnent de complications au niveau des pieds qui risquent d\'etre negligees. But Le but de l\'etude est de determiner la prevalence des neuropathies peripheriques ainsi que les complications au niveau des pieds chez des diabetiques suivis dans notre departement, en ambulatoire. Methode Une etude transversale a ete menee pendant six mois chez des diabetiques atteints d\'une neuropathie peripherique symptomatique et des individus apparemment sains. Resultats Sur les 322 patients etudies, 64 (19%) presentaient une neuropathie peripherique symptomatique. Les symptomes les plus souvent rencontres sont : les engourdissements ou picotements (65,6%), les crampes, des douleurs continues, une fatigabilite (14,1%) et une impression de brulure (10,9%). Une peau seche et craquelee, une hyperpigmentation, des callosities ainsi que des signes de mycoses etaient les lesions les plus souvent observees chez les patients diabetiques ayant une neuropathie peripherique. Aucun ulcere n\'a ete note chez les individus sains contrairement a la population diabetique ( 34,7%). Conclusion L\'attention est portee sur la necessite de surveiller et de diagnostiquer au plus tot les lesions cutanees chez les patients diabetiques. Par ailleurs, les lesions cutanees sont l\'expression de la severite de la neuropathie peripherique sous-jacente, chez ce type de patients. Keywords : Diabetes mellitus, foot complications, peripheral neuropathy, Afrique, diabete, complications, neuropathie peripherique, pied diabetique African Journal of Neurological Sciences Vol. 24 (1) 2005: pp. 7-12