Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Diabetic Foot Disease and opportunities for enhanced care: an audit of the cardiovascular risk factors in patients presenting to a tertiary referral High Risk Foot Service (#361)

Lili Yuen 1 , Matthew Malone 1 , Jessica White 1 , Annie Walsh 1 , Marion Harpur 2 , Erica Koo 2 , Karen Joshua 2 , Pietro DiCaccio 3 , Charbel Bejjani 3 , Eva Morris 3 , Namson S Lau 1
  1. LIVE DIAB CRU, Ingham Institute, University of New South Wales, Liverpool, NSW, Australia
  2. Podiatric Medicine, Liverpool Hospital, Liverpool, NSW, Australia
  3. Department of Medicine, Liverpool Hospital, Liverpool, NSW, Australia

BACKGROUND

Patients with diabetic foot disease (DFD) have high rates of metabolic risk factors and are at increased risk of cardiovascular, stroke and renal diseases1-3.  They regularly present to high risk foot services4 (HRFS), which may provide opportunities to screen for, treat and up-titrate management of these risk factors as well as increase their knowledge of their risk profile.

METHOD

We collected demographic and comorbid history, blood pressure, and assessments of renal function, lipids and HbA1c in 62 patients presenting to the Liverpool Hospital HRFS with diabetes mellitus (DM) and DFD.  Data collection is on-going

RESULTS

Preliminary results (mean ± SD) showed 66% of patients were male, mean age 58.9 ± 19 years; 97% Type 2 DM for 16.7 ± 9.3 yrs with mean HbA1c 8.4% ± 1.9.  Using the Australian absolute cardiovascular disease risk calculator our “average” patient scored 12%, which represented an increased 5-year risk of cardiovascular disease.  Other results showed mean blood pressure was 141/75 ± 25/11 mmHg; total cholesterol 4.5 ± 1.3 mmol/L, HDL 1.25 ± 0.3 mmol/L, cholesterol:HDL ratio 3.8 ± 1.3 .  Mean eGFR 60 ± 25 ml/min/1.73m2with 69% having detectable microalbuminuria (>3.4mg/mmol creatinine).  Full results pending.

CONCLUSION

DFD patients presenting to this HRFS were at increased risk for cardiovascular disease with mean HbA1c, blood pressure and cholesterol levels above target.  The HRFS may present an opportunity to monitor, up-titrate and educate patients regarding these risk factors.

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