Assessment of Biochemical Parameters and Other Risk Factors of Diabetes Mellitus Foot Ulcers at a Tertiary Health Center in Southwestern Nigeria

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A BSTRACT Background: Patients with diabetes mellitus are prone to many metabolic and biochemical derangements, especially when their blood glucose is not controlled. These metabolic and biochemical derangements can lead to many different complications which could have been prevented if their blood glucose level had been strictly controlled right from the period of diagnosis and strictly adhered to henceforth. Diabetes mellitus foot ulcer is one of the complications found in patients with uncontrolled diabetes mellitus. Diabetes foot ulcers have a complex and multifactorial pathogenesis which includes metabolic and biochemical factors, among other established risk factors. Aim: To determine the common biochemical and metabolic derangements associated with the diabetic foot ulcer. Materials and methods: This was a descriptive, retrospective, single-center study of 100 consecutively recruited adult type 2 diabetes patients managed for diabetes mellitus foot ulcer at the endocrinology unit of a Tertiary Care Hospital in South Western Nigeria (Lagos State University Teaching Hospital Ikeja, Lagos) from February 1, 2022 to February 8, 2023. Demographic and clinical data were obtained from the medical records of each patient using a pretested prestructured questionnaire. The Institutional Ethics Committee approved the study protocol (LREC/October 06, 1986). Data were analyzed using IBM SPSS statistics (Statistical Package for the Social Sciences) software. The power of significance was set at P < 0.05. Results: A total of one hundred clinical case records of subjects with diabetes mellitus foot ulcers were used for this study. The mean age of the subjects was 60.2 ± 10.9 years. The most common comorbidities were hypertension 54 (54.0%) followed by chronic kidney disease 7 (7.0%) and peripheral vascular disease 4 (4.0%). Most of the subjects HbA1c values were deranged. The majority, 36 (80.0%) of those in Wagner’s classification of foot ulcers stage 5, presented with dyslipidemia. More than half 13 (52.0%) of those in stage 4 had proteinuria, whereas 40 (60.0%) of the subjects in stage 2 had deranged creatinine values. There was no significant association between age, dyslipidemia, HbA1c, proteinuria, body mass index, serum creatinine, and DFU. Most of the subjects had stage 5 Wagner’s classification foot ulcers. Conclusion: Our study found some degree of associations between biochemical derangements and diabetic mellitus foot ulcers in patients with type 2 diabetes mellitus. These associations were, however not statistically significant.

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