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Rāwalpindi, Pakistan

Amjad S.,Benazir Bhutto Shaheed Hospital | Seetlani N.K.,Dow University of Health Sciences | Ahmed W.,Rawal Institute of Health science
Journal of the Liaquat University of Medical and Health Sciences | Year: 2016

BACKGROUND: With the increased life expectancy, there is rise in geriatric diabetic population. A knowledgeable diabetic in collaboration with physician can contribute to a successful diabetes management plan. Current study was conducted to determine the diabetes knowledge, its associations and risk factors in elderly type 2 diabetics. METHODS: This descriptive cross sectional study was conducted at outdoor Medicine Dept. Rawal Institute of Health Sciences Islamabad over 8 months period from January to August 2015. Geriatric type 2 diabetics (>65 years) were included. Critically ill patients, having physical or mental limitation to answer the questionnaire were excluded. The demographic details, socioeconomic class, literacy level, duration of diabetes, other modes of therapy and glycemic control documented. Michigan Diabetes Knowledge Questionnaire (DKQ-24) was applied with outcome of diabetes knowledge as good, acceptable and poor. Data analyzed by SPSS version 17 with significant p-value < 0.05. RESULTS: Among 163 diabetics (21.5% males and 78.5% females), mean age was 64.7+5.6 years and mean duration of diabetes 8.4+6.6 years. Diabetes knowledge was poor in 86(52.8%), acceptable in 37(22.7%) and good in 40(24.5%) diabetics. Poor diabetes knowledge was found to be associated with illiteracy, poverty, unsatisfactory glycemic control, practicing other modes of therapy and poor dietary control. CONCLUSION: The unsatisfactory diabetes knowledge in geriatric diabetic population needs to be addressed. Illiteracy and low socioeconomic class are the contributory factors in addition to advanced age. Imparting knowledge to geriatric group about diabetes and its complications, dietary advice supplemented by easy to interpret diet charts and literature may lead to empowerment of geriatric diabetics for better diabetic control and reduced diabetes related morbidity. © 2016, Liaquat University of Medical and Health Sciences. All rights reserved. Source


Amjad S.S.,Benazir Bhutto Shaheed Hospital | Shams N.,Rawal Institute of Health science | Zahra T.,Bolan Medical Complex Hospital
Journal of the Liaquat University of Medical and Health Sciences | Year: 2016

OBJECTIVE: To determine the various risk factors for diabetic foot ulcers and study their associations. To study the grades of diabetic foot ulcers at presentation. STUDY DESIGN: Comparative descriptive study. SETTING: Department of Medicine; PIMS Hospital, Islamabad. STUDY DURATION: 15th July 2012 to 15th Jan 2013. MATERIAL AND METHODS: 254 cases were selected after informed consent. Study group (A) comprises of 127 cases of type 2 diabetes with diabetic foot ulcer and control group (B) comprises of 127 cases of age and gender matched type 2 diabetics without foot ulcers. Patients having ulcer for ≥4 weeks, who underwent debridement, having serious systemic illness, type I diabetics and non-diabetic patients presenting with foot ulcer were excluded. Age, gender, duration of diabetes, duration of ulcer, glycemic control, presence of neuropathy and vascular disease were documented. Grading and Staging of ulcer was done according to New University of Texas Diabetic Wound Classification. Various risk factors were compared between the two groups. Data analyzed via SPSS version 17 with significant p-value < 0.05. RESULTS: Among 254 cases (68.5 % males & 31.5 % females); mean age was 55.9 + 10.79 (group A) versus 51.9 + 11.4 (group B). Mean duration of diabetes was longer in group A (9.36 + 6.05 years) vs. group B (7.39 + 4.89 years) (p = 0.016). Glycemic control was poor in group A (64.6 %) vs. group B (52 %) (p = 0.04). There was significantly more peripheral vascular disease in group A (47.2 %) vs. group B (29 %) (p = 0.005). Sensory neuropathy was more in group A (94.5 %) vs. group B (39.4 %) (p < 0.0001). Grade-I ulcer was present in 17.32 % cases, Grade-II in 37.79 % and Grade-III in 44.88 %. CONCLUSION: Neuropathy carries highest risk for diabetic foot ulcer, followed by peripheral vascular disease and poor glycemic control. Therefore diabetic patient must be educate about these risk factor, foot care and self-examination and to have regular screening by clinician. Appropriate glycemic control and timely medical and surgical intervention may reduce morbidity in diabetics. © 2016, Liaquat University of Medical and Health Sciences. All rights reserved. Source

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