title: Epidemiology of diabetic foot infections in an eastern Caribbean population: a prospective study.
abstract: BACKGROUND
  This study evaluates the epidemiology of diabetic foot infections in an Eastern Caribbean nation in order to direct public health preventive measures.
  
  
  METHODS
  We prospectively identified all patients with diabetic foot infections who were admitted to tertiary care hospitals across Trinidad and Tobago from July 2011 to June 2012. A questionnaire was used to collect data on demographics, patient knowledge, avoidance of risk factors for chronic diseases (a proxy to unhealthy lifestyles), and glycosylated hemoglobin measurements on admission as an index of blood glucose control. The data were analyzed with statistical software.
  
  
  RESULTS
  There were 446 patients with diabetic foot infections (mean age = 56.9 years, standard deviation = 12.4 years). Most patients had Type 2 diabetes (93.3%) and were of Indo-Trinidadian (49.1%) or Afro-Trinidadian (41.7%) descent. There were preexisting complications of diabetes in 82.9% of patients with Type 2 diabetes: foot infections requiring hospitalization (70.2%), ischemic heart disease (32.5%), renal impairment (13.7%), and retinopathy (22.1%). Despite most patients claiming compliance with treatment, 75% had glycosylated hemoglobin levels above 7.1% at presentation, and 49.3% continued unhealthy lifestyles. Despite the high prevalence of diabetic complications at admission, and despite 70% having had previous hospitalization for treatment of foot infections, only 57.4% of patients reported ever being counseled or taught about foot care by medical personnel.
  
  
  CONCLUSIONS
  There is room for improvement in public health strategies to prevent diabetic foot complications in this setting. Such strategies should focus on patient education with emphasis on lifestyle modification and compliance with medical therapy.
authors.affiliation: Department of Surgery at the University of West Indies in San Fernando, Trinidad and Tobago. ssI201190@yahoo.com
authors.forename: Shariful
authors.initials: S
authors.lastname: Islam
authors.forename: Patrick
authors.initials: P
authors.lastname: Harnarayan
authors.forename: Shamir O
authors.initials: SO
authors.lastname: Cawich
authors.forename: Steve
authors.initials: S
authors.lastname: Budhooram
authors.forename: Vinoo
authors.initials: V
authors.lastname: Bheem
authors.forename: Vijai
authors.initials: V
authors.lastname: Mahabir
authors.forename: Shiva
authors.initials: S
authors.lastname: Ramsewak
authors.forename: Imran
authors.initials: I
authors.lastname: Aziz
authors.forename: Vijay
authors.initials: V
authors.lastname: Naraynsingh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology; D017719:Diabetic Foot / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012874:Skin Diseases, Infectious / Q000150:complications / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D014300:Trinidad and Tobago / Q000453:epidemiology; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin