Clinical and epidemiological profile of patients with diabetic foot and frequency of lower-limb amputation at the General Hospital of Coronel Oviedo, Paraguay
DOI:
https://doi.org/10.5281/zenodo.22163209Keywords:
diabetes mellitus, diabetic foot, amputation, lower extremity, glycated hemoglobin, ParaguayAbstract
Introduction: Diabetic foot is the leading cause of non-traumatic lower-limb amputation; its features in general hospitals of inland Paraguay have hardly been described. The aim was to describe the clinical and epidemiological profile of patients with diabetic foot attended at the General Hospital of Coronel Oviedo during 2025 and the frequency and level of amputation in that series. Materials and methods: An observational, descriptive, retrospective study of the medical records of patients with diabetes mellitus and diabetic foot attended between January and October 2025 (35 records with complete data), summarized with frequencies, without hypothesis testing. Results: Age clustered at 60 years or older (21 patients, 60.0%) and sex was nearly even (18 men, 51.4%). Type 2 diabetes (82.9%) and a duration of 10 years or more (80.0%) predominated. Metabolic control was inadequate in 32 patients (91.4%). Arterial hypertension was the most frequent recorded comorbidity (34.3%). Eighteen patients (51.4%) underwent amputation: 12 (66.7%) at a minor level and 6 (33.3%) at a major level. Conclusions: Diabetic foot presenting to the general hospital mainly affected older people with long-standing type 2 diabetes and poor metabolic control, and just over half ended in amputation, mostly minor. The findings support strengthening diabetes control and foot screening in primary care.References
Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119. https://doi.org/10.1016/j.diabres.2021.109119
Zhang Y, Lazzarini PA, McPhail SM, van Netten JJ, Armstrong DG, Pacella RE. Global disability burdens of diabetes-related lower-extremity complications in 1990 and 2016. Diabetes Care. 2020;43(5):964-74. https://doi.org/10.2337/dc19-1614
Savelieff MG, Elafros MA, Viswanathan V, Jensen TS, Bennett DL, Feldman EL. The global and regional burden of diabetic peripheral neuropathy. Nat Rev Neurol. 2025;21(1):17-31. https://doi.org/10.1038/s41582-024-01041-y
Pop-Busui R, Boulton AJM, Feldman EL, Bril V, Freeman R, Malik RA, et al. Diabetic neuropathy: a position statement by the American Diabetes Association. Diabetes Care. 2017;40(1):136-54. https://doi.org/10.2337/dc16-2042
Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y. Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis. Ann Med. 2017;49(2):106-16. https://doi.org/10.1080/07853890.2016.1231932
McDermott K, Fang M, Boulton AJM, Selvin E, Hicks CW. Etiology, epidemiology, and disparities in the burden of diabetic foot ulcers. Diabetes Care. 2023;46(1):209-21. https://doi.org/10.2337/dci22-0043
Armstrong DG, Tan TW, Boulton AJM, Bus SA. Diabetic foot ulcers: a review. JAMA. 2023;330(1):62-75. https://doi.org/10.1001/jama.2023.10578
Thorud JC, Plemmons B, Buckley CJ, Shibuya N, Jupiter DC. Mortality after nontraumatic major amputation among patients with diabetes and peripheral vascular disease: a systematic review. J Foot Ankle Surg. 2016;55(3):591-9. https://doi.org/10.1053/j.jfas.2016.01.012
Armstrong DG, Swerdlow MA, Armstrong AA, Conte MS, Padula WV, Bus SA. Five year mortality and direct costs of care for people with diabetic foot complications are comparable to cancer. J Foot Ankle Res. 2020;13(1):16. https://doi.org/10.1186/s13047-020-00383-2
Rossboth S, Lechleitner M, Oberaigner W. Risk factors for diabetic foot complications in type 2 diabetes—a systematic review. Endocrinol Diabetes Metab. 2020;4(1):e00175. https://doi.org/10.1002/edm2.175
Sen P, Demirdal T, Emir B. Meta-analysis of risk factors for amputation in diabetic foot infections. Diabetes Metab Res Rev. 2019;35(7):e3165. https://doi.org/10.1002/dmrr.3165
Nouira S, Ach T, Bellazreg F, Ben Abdelkrim A. Predictive factors for lower limb amputation in type 2 diabetics. Cureus. 2023;15(6):e39987. https://doi.org/10.7759/cureus.39987
Huang J, Yang J, Qi H, Xu M, Xu X, Zhu Y. Prediction models for amputation after diabetic foot: systematic review and critical appraisal. Diabetol Metab Syndr. 2024;16(1):126. https://doi.org/10.1186/s13098-024-01360-6
Schaper NC, van Netten JJ, Apelqvist J, Bus SA, Fitridge R, Game F, et al. Practical guidelines on the prevention and management of diabetes-related foot disease (IWGDF 2023 update). Diabetes Metab Res Rev. 2024;40(3):e3657. https://doi.org/10.1002/dmrr.3657
Musuuza J, Sutherland BL, Kurter S, Balasubramanian P, Bartels CM, Brennan MB. A systematic review of multidisciplinary teams to reduce major amputations for patients with diabetic foot ulcers. J Vasc Surg. 2020;71(4):1433-1446.e3. https://doi.org/10.1016/j.jvs.2019.08.244
Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med. 2017;376(24):2367-75. https://doi.org/10.1056/NEJMra1615439
Bilal A, Amarasena DK, Pillai A. Socioeconomic deprivation as a predictor of lower limb amputation in diabetic foot disease. Cureus. 2023;15(8):e43416. https://doi.org/10.7759/cureus.43416
Cañete Cañete NA, López Esquivel NY, Romero Gaona NMI, López Esquivel NG, Ortega Filártiga E. Estadificación y tratamiento del pie diabético en Urgencias del Hospital Nacional de Itauguá, Paraguay, año 2024. Rev Virtual Soc Parag Med Interna. 2025;12(1):e12122521. https://doi.org/10.18004/rvspmi/2312-3893/2025.e12122521
Ovelar L, Izcurdia C, Quiñonez L, Bejarano R, González S, Paredes B, et al. Caracterización de pacientes con pie diabético en el servicio de urgencias del Hospital de Clínicas, Paraguay. Periodo 2015-2016. Rev Cient Cienc Salud. 2021;3(1):63-70. https://doi.org/10.53732/rccsalud/03.01.2021.63
Colucci A, Giubi J. Impacto económico de desbridamientos quirúrgicos y amputaciones de miembros inferiores en pacientes diabéticos. An Fac Cienc Med (Asunción). 2023;56(3):51-7. https://doi.org/10.18004/anales/2023.056.03.51
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Andreia Carvalho Gandra Melo, Damiana Souza Pereira Carvalho, Katlyn Tamires de Oliveira, Eliana María Inés Chamorro Krauer (Autor/a)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Articles are distributed under the Creative Commons Attribution 4.0 International — CC BY 4.0 licence. Authors retain copyright and grant the journal the right of first publication. Any reuse must acknowledge authorship, cite the original source and indicate whether changes were made.
