Diabetes, hand and/or foot ulcers: a cross-sectional hospital-based study in Port Harcourt, Nigeria.
OBJECTIVE
The study aimed to establish the prevalence of diabetes mellitus and the pattern of diabetic hand and foot ulcers in hospitalized adult patients in a teaching hospital in Port Harcourt, Nigeria.


METHODS
All medical admission at the University of Port Harcourt Teaching Hospital between January 2000 and April 2001 were included in this cross-sectional study. Diabetes mellitus was diagnosed based on a fasting venous plasma glucose >or=7.0 mmol/l or a 2-h post-prandial venous plasma glucose level of >or=11.1 mmol/L using the glucose oxidase method. Data was processed for the 60 diabetic patients with limb ulcers excluding ulcers from major trauma.


RESULTS
The prevalence of diabetes mellitus was 38.1% (95% CI=34.8-41.4) among medical in-patients; while hand and foot ulcer was 19.1% among diabetic patients. The left lower limb ranked highest in ulcer involvement (32/60); hand ulcers were found in 5 cases (8.3%). Twenty (33.3%) of the patients had a previous limb ulcer. In 31 patients (51.7%) the ulcers evolved spontaneously without an identifiable cause (p-value=0.00). By Wagner's Grading System, Grade III lesions ranked highest (21/64).


CONCLUSIONS
A high prevalence of hand and foot ulcers was confirmed among patients with diabetics, which are common indications for hospitalization, and usually associated with long hospital stay with adverse outcomes including amputation and death. Diabetes education needs to be stepped-up, with emphasis on foot care and early presentation to hospital in the event of limb ulceration.
Unachukwu
Chioma
C
College of Health Sciences, University of Port Harcourt, Port Harcourt, Nigeria.
Babatunde
Seye
S
Ihekwaba
Anele E
AE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D017719:Diabetic Foot / Q000453:epidemiology; D005534:Foot Diseases / Q000453:epidemiology; D016523:Foot Ulcer / Q000453:epidemiology*; D006229:Hand Dermatoses / Q000453:epidemiology*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D012883:Skin Ulcer / Q000453:epidemiology*