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Journal of Diabetes & Metabolic Disorders
Published in: Journal of Diabetes & Metabolic Disorders 1/2021

01-06-2021 | Diabetic Foot | Research article

Non-vascular contributing factors of diabetic foot ulcer severity in national referral hospital of Indonesia

Authors: Em Yunir, Dicky L. Tahapary, Tri Juli Edi Tarigan, Dante Saksono Harbuwono, Yoga Dwi Oktavianda, Melly Kristanti, Eni Iswati, Angela Sarumpaet, Pradana Soewondo

Published in: Journal of Diabetes & Metabolic Disorders | Issue 1/2021

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Abstract

Purpose

Diabetic foot ulcer (DFU) is a common chronic complication of type 2 diabetes mellitus (T2DM) in Indonesia, with a prevalence of 7.3%. However, the characteristics of these patients remain unclear. We investigated the characteristics of patients with DFU without peripheral arterial disease (PAD) and analyzed non-vascular factors related to severity of DFU in a tertiary care national referral hospital in Indonesia.

Methods

This was a cross-sectional study including 123 hemodynamically stable DFU patients without PAD recruited from Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia from 2010–2015.

Results

DFU patients were predominantly over 50 years old (75.6%) and diagnosed with T2DM for 5 years with poor glycemic control (82.7%) and peripheral neuropathy (91.3%). Most patients had anemia (86.7%), leukocytosis (84.6%), and were undernourished, as characterized by a low lipid profile (90.8%) and hypoalbuminemia (83.7%). Most had extensive size of ulcer at the initial visit, with a median size of 16.23 (2.92–60.16) cm2. Ulcers were mostly located of the forefoot (62.5%) and were caused by mechanical trauma (46.2%). Bivariate analysis revealed that significant factors for the development of DFU were related to DFU size, including duration of T2DM (p = 0.04), leukocyte levels (p =  < 0.01), and thrombocyte levels (p =  < 0.01). Multivariate analysis showed leucocyte (p = 0.03) and thrombocyte (p = 0.023) had significantly correlated with DFU severity.

Conclusion

Leucocyte and thrombocyte may be the greatest contributing non-vascular factors for severity of DFU in Indonesia.
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Metadata
Title
Non-vascular contributing factors of diabetic foot ulcer severity in national referral hospital of Indonesia
Authors
Em Yunir
Dicky L. Tahapary
Tri Juli Edi Tarigan
Dante Saksono Harbuwono
Yoga Dwi Oktavianda
Melly Kristanti
Eni Iswati
Angela Sarumpaet
Pradana Soewondo
Publication date
01-06-2021
Publisher
Springer International Publishing
Keyword
Diabetic Foot
Published in
Journal of Diabetes & Metabolic Disorders / Issue 1/2021
Electronic ISSN: 2251-6581
DOI
https://doi.org/10.1007/s40200-021-00827-x

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