Assessing diabetic patients at risk of developing foot ulcers in Freetown, Sierra Leone

Introduction:Diabetes Mellitus is a global health issue,though current prevalence data is lacking Sierra Leone has an increasing number of diagnosed and undiagnosed diabetes.Lack of education and self-care,poor adoption of healthy lifestyle may be the main factors leading to an increased risk of diabetic foot ulcers.Objectives:To identify patients with diabetes at risk of developing foot ulcers,diabetic neuropathy,peripheral artery disease and to investigate the association between independent risk factors involved in development of foot ulcers and other clinically related factors.Methods:Study was done at two sites,Connaught hospital and a clinic in Freetown.A standardized questionnaire was administered for risk assessment of diabetic ulcers.A total of 231 participants(Ages 45-75 years)were recruited via systematic random sampling.Descriptive statistics was used to analyze data using SPSS.Results:Majority of participants(64.5%)were diagnosed with diabetes within 1-5 years,5.5%and 13.4%had eye and kidney disease respectively.Protective sensation evaluation revealed that 38.5%had loss of protective sensation and 19%had suspected peripheral arterial disease with absent pulse at the posterior tibial artery and dorsalis pedis.Age,occupation,years since diagnosis and type of diabetes was significantly associated with high risk of developing diabetic foot ulcers with a P value<0.005.Risk Categorization of participants revealed 76%at low risk while those at moderate,high and highest risks were 20%,17%and 3.5%respectively.Individuals with prior kidney disease,eye problems and previous history of amputation had greater loss of protective sensation,absent pulse,and tingling sensation at extremities.Conclusion:There’s great need for health care workers to become diabetes educators to offer proper services like diabetes foot examination to prevent diabetes ulcers which leads to amputation.Detecting diabetic patients at risk for diabetic foot ulcers will go a long way to prevent future amputations and other associated complications.

Assessing people at risk of developing type 2 diabetes in Freetown, Sierra Leone

Objective:This study aims to estimate the proportion of adults that are at high risk of developing Type 2 diabetes mellitus,and to investigate the association of participants at high risk for developing diabetes with various risk factors.Methods:A 2-yearprospective community based cross-sectional design was carried out in Freetown using the standardized Finnish Diabetes Risk Score assessment questionnaire,at two community pharmacies in the East,Central Freetown,and at a Peripheral Health Unit in the west where participants were randomly selected.Results:The study included a total of 1013 adults(ages 18 years and above)which reveals that 36.5%had a family history of diabetes mellitus and 42.8%were physically inactive.Assessment of obesity depicted 35.4%have class 1–2 obesity,with 19.4%males and 35.4%females having central obesity respectively.In terms of risk score,17.8%of total participants were found to be at high risk for developing type 2 diabetes.Conclusion:There is a high prevalence of risk for developing diabetes among residents of Freetown.Major risk factors such as,age,family history of Diabetes,obesity,high blood pressure contributed to this.Increase in obesity rate was also seen especially among females having a wider waist circumference and Body Mass Index.Interventions to adequately address issues of physical inactivity,poor dietary habits are highly needed to prevent those at high risk of developing type 2 diabetes mellitus.