Improving glycaemic and cardiovascular risk assessment and management in diabetic foot ulcer patients
Published Date: 07th October 2020
Publication Authors: Roberts H, Kejem H, Furlong NJ
Introduction
Diabetic foot ulcer increases the risk of cardiovascular disease, nephropathy and mortality. There is over a twofold increase in mortality compared to patients without diabetic foot ulcer, regardless of other risk factors.
Aim
To improve glycaemic and cardiovascular risk assessment and management on first presentation to the multidisciplinary diabetic foot clinic.
Method
Retrospective study between January and March 2019 of 91 patients on first attendance to the multidisciplinary diabetic foot clinic. Information was collected from the electronic records.
Results
In total, 91 patients were audited of which type 2 diabetes accounted for 86.8%, type 1 diabetes was 8.7%. The majority did not have blood pressure targets documented. However, 59.3% had blood pressure <130/80 while 37.3% blood pressure >140/80. Non‐smokers accounted for 78% while smokers and ex‐smokers represented 12.0% and 6.5% respectively. Smoking cessation advice was given to 63.6% patients. No ACR was documented in 72.5% while 14.2% having an ACR > 3 and 9.8% ACR < 3. Antiplatelet therapy was present in 42.8% patients while 56.2% were not. Aspirin made up 66.6% followed by 30.7% on clopidogrel and 2.5% on dual therapy. 39.5% of those not on antiplatelets were on oral anti‐coagulant. Statins accounted for 73.6% and of those not on statins 6 were commenced on atorvastatin. Target HbA1C was documented for 85.7% of which 35% achieved target.
Conclusion
The foot clinic proforma will be updated to include a section on cardiovascular risk assessment. All staff in the foot clinic will be educated to assess for cardiovascular factors.
Roberts, H; Kejem, H; Furlong, N. (2020). Improving glycaemic and cardiovascular risk assessment and management in diabetic foot ulcer patients. Diabetic Medicine. 37 (S1), 73-74