Journal of Universal Surgery

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Effect of Modifiable Risk Factors in Diabetic Foot Management

Manikanta KS and Monisha Gunasekaran*

Background: Persons with diabetes, the prevalence of foot ulcers ranges from 4 to 10% and its lifetime incidence may be as high as 25%. Modifiable factors including BMI and HbA1c have gained special attention of researchers and have been extensively studied in relation with diabetic foot ulcers, gangrene, and limb amputation.

Methods: A prospective study on 102 patients with diabetic foot in Bowring and Lady Curzon and Victoria hospital between July 2018 to December 2018. We sought to compare the outcome of diabetic foot healing between individuals with normal and high BMI and assess the relative risk of modifiable factors (BMI, HbA1c and smoking) in lower extremity amputation in diabetic foot.

Results: Higher BMI and HbA1c were strongly associated with non salvagibility of lower limb, though smoking was found to have a moderate correlation. Normal BMI individuals were found to have a relatively good healing than high BMI cases.

Conclusion: BMI, HbA1c and smoking, these three modifiable risk factors prove to be primary predictors of outcome in diabetic wound healing. From the present comparative study, persons with higher BMI had a more risk of lower extremity amputation hence “Obesity paradox proves to be a fallacy in diabetic foot healing”.