engleski

Draft Program of Prevention of Diabetic Foot Development and Lower Extremity Amputation in Persons with Diabetes Mellitus

Patients with diabetes mellitus have a twenty-fold risk of lower limb amputation recorded in the general population. In most countries, the incidence of leg amputation has been on a decrease over the last two decades as the result of organized preventive actions, improvement in surgical techniques, and a multidisciplinary approach to the issue. However, there are still examples of unchanged incidence despite specific measures undertaken. The objective of the planned program is to upgrade foot care in diabetes patients at Vuk Vrhovac University Clinic and to reduce the number of amputations in patients routinely examined at the Clinic by 50% by the year 2010 (during a 5- year period). The program will be carried out in three stages: analysis of the current situation ; implementation of prevention program ; and evaluation of results. The incidence of foot ulcers and amputations will be estimated by the analysis of records of all patients examined during September and October 2005. Patient education on foot care has so far been carried out at Outpatient Department as part of the general patient education, which has been evaluated as inadequate in both the quality and quantity. Feet have not been examined in all patients. The program target population are all persons with diabetes mellitus examined during a year, i.e. 15, 000 persons. The program consists of three substages: screening of feet at risk (case history, feet and footwear inspection, pulse test and test for neuropathy (monofilament, tuning fork or cotton wool)), education of patients (brief introductory and extended education carried out by a nurse using a structured questionnaire), and for those found to be at risk of amputation referral to additional work-up. Records of patients examined during September and October will be analyzed annually, and statistical analysis will include all patients who underwent the given program.

diabetes mellitus ; diabetic foot ; lower limb amputation ; epidemiology ; incidence ; prevention

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