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Villanova d'Asti, Italy

De Corrado G.,SOC Malattie Metaboliche e Diabetologia | Ambruosi M.,SOC Malattie Metaboliche e Diabetologia | Repetti E.,SOC Malattie Metaboliche e Diabetologia | Viglione P.,SOC Malattie Metaboliche e Diabetologia | Gentile L.,SOC Malattie Metaboliche e Diabetologia
Giornale Italiano di Diabetologia e Metabolismo | Year: 2010

Diabetic ulcer is a common and feared complication of diabetes with elevated economic and social impact. The distal motor sensory neuropathy is the main risk factor for diabetic ulcers. Neuropathy, but also the limited ability to take care of themselves and impaired eyesight, can make the diabetic patients unaware to have an ulcer. Often the ulcers are noticed late and as a consequence there is a late referral to healthcare professional. Regular feet inspection and education of the patient and/or their family are effective and solid means for prevention. Specific prospective studies on the incidence of neuropathic diabetic foot ulcers of which the patients was unaware and discovered occasionally by healthcare professional are lacking. Therefore we performed a prospective study to assess the annual incidence of new diabetic ulcers not referred by patients in the diabetic population followed for the secondary prevention of neuropathic ulcers in our division. In the year of reference, ninety subjects, in secondary prevention because of previous neuropathic foot ulcers and already submitted to educational therapy, were regularly followed for the secondary prevention in our diabetic division. Thirty six subjects (40%) had neuropathic ulcer relapses; of these, ten (27.8% of the ulcerated ones) were incidentally identified only at the time of the follow-up visits. Our study shows that not self-referred diabetic ulcers are frequent in neuropathic subjects with a previous ulcer with an annual incidence of 27.8% in our population. Among the subjects unaware of the foot ulcer, depression, psychosis and social problems were prevailing. Source

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