title: Prevention of lower-limb lesions and reduction of morbidity in diabetic patients.
abstract: OBJECTIVE
  To assess the impact of a diabetic foot outpatient clinic on reducing the morbidity of this disease, with emphasis on lower-limb lesions.
  
  
  METHODS
  This was a prospective observational study with a target population of 30 cases out of a total of 77 patients in the diabetic foot outpatient clinic. The inclusion criterion was that data relating to laboratory tests, clinical examinations, neuropathic and vascular tests and the elbow-arm index needed to be available from all the patients, with repetition after 18 months of follow-up, so as to analyze their evolution. The statistical analysis was done using the McNemar chi-square test for dependent samples.
  
  
  RESULTS
  The patients' mean age was 61 years. All of them had type 2 diabetes mellitus (DM), which had started 14.5 years previously, on average, and 20% had neuropathies. After 18 months, there was no change in the frequency of lesions in diabetes target organs (p = 1.000) or in the neuropathy rate (p = 1.000). However, there were significant improvements in neuropathic symptoms, from 70% to 36.7% (p = 0.035), and in peripheral arterial disease, from 73.3% to 46.7% (p = 0.021). There was also a decrease in ulcers from 13.3% to 10% (p = 1.000).
  
  
  CONCLUSIONS
  Creation of specialized outpatient clinics for prevention of diabetic foot is a viable investment, which has low cost compared with the high costs generated through the complications from this disease. This approach noticeably improves the patients' quality of life, with reduction of morbidity.
authors.affiliation: Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil.
authors.forename: Antônio Homem
authors.initials: AH
authors.lastname: do Amaral Júnior
authors.affiliation: Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil.
authors.forename: Leonã Aparecido Homem
authors.initials: LA
authors.lastname: do Amaral
authors.affiliation: Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil.
authors.forename: Marcus Gomes
authors.initials: MG
authors.lastname: Bastos
authors.affiliation: Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil.
authors.forename: Luciana Campissi
authors.initials: LC
authors.lastname: do Nascimento
authors.affiliation: Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil.
authors.forename: Marcio José Martins
authors.initials: MJ
authors.lastname: Alves
authors.affiliation: School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Marco Antonio Percope
authors.initials: MA
authors.lastname: de Andrade
keywords: Amputation; Diabetes mellitus; Diabetic neuropathies; Foot; Infection; Peripheral vascular diseases; Primary prevention; Ulcer