Prevention of diabetic foot in hospital consultation

Abstract

Diabetic foot is a chronic complication of diabetes whose significance is determined by high morbidity and mortality, loss of quality of life and emotional repercussions for those affected and their environment. But it is preventable.

Despite all the evidence, in Spain, the data provided by the Autonomous Communities to the National Health System show a low percentage of foot examination records in the clinical histories of patients with diabetes mellitus.

The main objective of this study was to evaluate the feasibility and usefulness of incorporating a complementary form in the Electronic Medical Record to ensure the standardized inclusion of the necessary data to guide and optimize the process of prevention and early diagnosis of diabetic foot in hospital consultation. The specific objectives were to determine the percentage of patients with diabetic foot ulcers, to determine the percentage of diabetic foot risk factors among patients attending hospital consultation who did not undergo foot examination in Primary Care, and to stratify these patients according to risk.

Descriptive study of 487 patients evaluated in the Endocrinology Department of the Hospital Universitario Central de Asturias hospital during the years 2021 and 2022, in whose medical records there was no record of Foot Examination. A validated form was created to allow such registration, including it in the electronic medical record.

A total of 487 patients with a mean age of 59 years were recruited. Ninety-three percent of the patients had some visible alteration in their feet. Seven percent of the patients had active ulcers that were not receiving professional follow-up. Only 2% of the patients wore inappropriate footwear. Sensitivity was altered in 9% and arterial involvement in 8%. After risk stratification, 27.6% had a foot at risk.