Diabetic foot complications in Malta : prevalence of risk factors

Abstract

The main objective of this research was to identify the prevalence of diabetes-related lower extremity complications in a cohort of Maltese patients living with type 2 diabetes. A retrospective study was conducted on a cohort of 243 patients living with type 2 diabetes mellitus in two Maltese Health Centre catchment areas. A convenience sampling was adopted to recruit subjects from a local pilot diabetes foot screening program. The clinical assessments used during this screening program were based on validated and previously published tools such as: neuropathy disability score, vibration perception threshold, Semmes–Weinstein monofilaments, vascular status and foot deformities were evaluated. The results from this study demonstrate that risk factors for foot deterioration and ulceration are common in Maltese population living with type 2 diabetes. Whilst, metabolic outcomes such as hypertension and dyslipidaemia were present in most subjects, peripheral vascular disease, peripheral sensory neuropathy and foot deformities were also common. Twenty-six per cent of the sample had to be referred for further vascular assessment following this screening program due to their critical vascular status. A significant proportion of Maltese participants living with type 2 diabetes presented with vascular insufficiency, abnormal neural function and deformities in the feet. Metabolic outcomes such as high blood pressure and high levels of cholesterol were also highly prevalent. Strengthening of existing screening structures is imperative in order to reduce the burden of this disease in Malta.