Type 2 Diabetes Mellitus Clinical Trial
Official title:
Clinical Profile and Laboratory Finding of Diabetic Foot Ulcers From Tertiary Hospitals in Bali
The investigators want to obtain the clinical profile, hematological profile, and biochemical profile from diabetic foot ulcer (DFU) patient.
This study is a retrospective descriptive study reviewing the medical records of diabetic
foot patients who were admitted to Sanglah General Hospital for surgical procedure. Sanglah
General Hospital is a provincial hospital located in Denpasar, Bali, which is the central
referral hospital in Bali and Nusa Tenggara islands as known as a tertiary hospital.
All DFU patients who underwent surgical procedures in Sanglah General Hospital operating
theatre were included in the study. All patient medical records were provided by our hospital
information center system. A diagnosis of diabetes mellitus was defined and confirmed from
ICD (International Classification of Diseases)-10 code E11.622 for "Type 2 Diabetes Mellitus
with other skin ulcers".
Data which we collected from the hospital information center system were further addressed
into different aspects, which comprised of personal data, DFU severity, diabetes mellitus
duration, ulcer duration, treatment procedures, and laboratory results. Based on our main
objective of this study, we divide the laboratory results into two groups, hematological and
blood chemistry profile. The variables selected in the hematological profile were hemoglobin,
hematocrit, leukocyte and differential counts, and platelet. The variables which were
included in blood chemistry profile are alanine aminotransferase (ALT), aspartate
aminotransferase (AST), serum albumin, random blood glucose, glycated hemoglobin (HbA1c),
blood urea nitrogen (BUN), serum creatinine, serum sodium, serum potassium, prothrombin time
(PTT), activated partial thromboplastin time (APTT), and international normalized ratio
(INR).
The protocol of DFU management in our hospital included diagnosis and treatment of infection
(local and systemic), assessment of patient's diabetic status, treatment of infection,
diabetes mellitus, and wound care, and also surgical procedure, such as sharp debridement and
amputations. The procedures were classified into five categories, consist of debridement,
amputation of the fingers, transmetatarsal amputation, amputation below the knee, and
amputation above the knee. DFU severity is classified into five different grades, based on
Wagner's diabetic foot classification. In our hospital, patients with diabetic foot problems
were evaluated and treated by a team consisting of surgeons, endocrinologists,
microbiologists, rehabilitation specialists, nutritionists, and nurses.
For the statistical analyses, variables were assessed using the program IBM SPSS statistics
version 23.0 for Windows (IBM Corporation, New York, USA). All numerical data were summarized
as mean ± standard deviation, and categorical variables were summarized as frequency and
percentage. Our method is about to use every available data to descriptively picture
laboratory characteristics in DFU patients.
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