K Kumar1, W Snowdon2, S Ram3, S Khan3, M Cornelius4, I Tukana5, S Reid6. 1. Ministry of Health Fiji/Diabetes Fiji Inc, Suva, Fiji. 2. C-POND, Deakin, University and Fiji National University, Suva, Fiji. 3. Fiji National University, Suva, Fiji. 4. Fiji Health Sector Support Program Fiji, Suva, Fiji. 5. Ministry of Health, Suva, Fiji. 6. The Australian Centre for International and Tropical Health School of Population Health, The University of Queensland, Herston, Queensland, Australia.
Abstract
SETTING: The Colonial War Memorial Hospital (CWMH) in Fiji. OBJECTIVE: To determine the characteristics of patients with diabetes mellitus (DM) who underwent lower limb amputations at the CWMH from 2010 to 2012. DESIGN: This was a retrospective review of data contained in operating theatre registers and clinical records of DM patients who had undergone amputations during the study period. RESULT: Of the 938 amputations performed at the CWMH during the study period, significantly more patients were male than female (54.1% vs. 45.9%) and more i-Taukei (indigenous Fijian) than Indo-Fijian (71% vs. 26.2%); 15.9% of patients had not previously been diagnosed as having DM when they presented with foot sepsis. The rate of smoking was highest in male i-Taukei patients. A large proportion of patients (76.8%) had poor glycaemic control. CONCLUSION: This study suggests that male i-Taukeis are most at risk, and that uncontrolled DM is a significant factor associated with amputations. There is a need to strengthen DM screening and improve glycaemic control. Foot care education needs to be implemented at diagnosis and re-enforced with regular clinic visits and complication screening sessions.
SETTING: The Colonial War Memorial Hospital (CWMH) in Fiji. OBJECTIVE: To determine the characteristics of patients with diabetes mellitus (DM) who underwent lower limb amputations at the CWMH from 2010 to 2012. DESIGN: This was a retrospective review of data contained in operating theatre registers and clinical records of DMpatients who had undergone amputations during the study period. RESULT: Of the 938 amputations performed at the CWMH during the study period, significantly more patients were male than female (54.1% vs. 45.9%) and more i-Taukei (indigenous Fijian) than Indo-Fijian (71% vs. 26.2%); 15.9% of patients had not previously been diagnosed as having DM when they presented with foot sepsis. The rate of smoking was highest in male i-Taukei patients. A large proportion of patients (76.8%) had poor glycaemic control. CONCLUSION: This study suggests that male i-Taukeis are most at risk, and that uncontrolled DM is a significant factor associated with amputations. There is a need to strengthen DM screening and improve glycaemic control. Foot care education needs to be implemented at diagnosis and re-enforced with regular clinic visits and complication screening sessions.
Authors: Brian Kennon; Graham P Leese; Lynda Cochrane; Helen Colhoun; Sarah Wild; Duncan Stang; Naveed Sattar; Donald Pearson; Robert S Lindsay; Andrew D Morris; Shona Livingstone; Matthew Young; John McKnight; Scott Cunningham Journal: Diabetes Care Date: 2012-09-25 Impact factor: 19.112