A comparison of patients with diabetes mellitus hand and foot syndromes

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Ijeoma, A.R
Okunowo, B.O
Odeniyi, I.A
Olopade, O.B
Fasanmade, O.A
Ohwovoriole, A.E
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International Society of Endocrinology/SEMDSA
BACKGROUND: Diabetes mellitus (DM) is characterized by the development of chronic complications including diabetes mellitus foot syndrome (DMFS) and diabetes hand syndrome (DHS). Diabetic foot ulcers are extensively characterized in Nigeria but information on DHS appears limited. OBJECTIVE: To present and compare the features of patients with DHS versus those with DMFS and to raise awareness about DHS. METHODS The ward admission charts of patients with DHS and DMFS were reviewed for twelve months from February 1st, 2017 to January 1st, 2018. The data obtained from records of each patient included age, sex, type and duration of DM, mode of presentation, and outcome of hospitalization. The risk factors that were considered included family history of diabetes mellitus, history of smoking, presence or absence of peripheral neuropathy, and peripheral vascular disease. RESULTS Table 1 shows the comparison of the features of DHS and DMFS. It shows that people with DHS had more dry gangrene and people with DMFS had more wet gangrene. There were more people with co-existing hypertension in DMFS. None of the people with DHS had co-existing hypertension., Both had poor glycaemic control. DISCUSSION/CONCLUSION • The middle and index fingers of the right hand are mostly affected in DHS while the left foot is more affected in DMFS. DHS is often preceded by trivial injuries (e.g. fishbone, crayfish uropod) while DMFS is mostly preceded by spontaneous blisters. •The most common risk factor seen in all DHS is poor glycaemic control while peripheral vascular disease is more common in DMFS. •Both appear to affect mostly women but more so in women following trivial injuries from kitchen mishaps and this may be due to the fact that the majority of the women with DHS were housewives. RECOMMENDATIONS •Focus on patient education •Ensure good glycaemic control •Ensure early presentation
Diabetes mellitus; diabetes mellitus hand syndrome; tropical diabetes hand syndrome; fish bone, Crayfish uropod, outcome
Ijeoma AR, Okunowo BO, Odeniyi IA, Olopade OB, Fasanmade OA, Ohwovoriole AE. A comparison of patients with diabetes mellitus hand and foot syndromes. ISE/SEMDSA book of abstracts 2018