**Global Impact of Diabetic Foot Complications**

**1** 

**Possible Diabetic-Foot Complications** 

Ezera Agwu1, Ephraim O. Dafiewhare2 and Peter E. Ekanem3

In Sub-Saharan Africa, fast uncontrolled urbanization and changes in standard of living are responsible for the rising epidemic of diabetes mellitus and the observed increase presents a substantial public health and socioeconomic burden in the face of scarce resources (Mbanya et al., 2010). Ten to fifteen percent of diabetic patients develop foot ulcers at some stage of their lives and nearly fifty percent of all diabetes-related admissions are due to diabetic foot problems (Kumar and Clark, 2009). The epidemiology of Ketosis-prone atypical diabetes in Africans is not well understood because of scarce data for pathogenesis and subtypes of diabetes. The prevalence of undiagnosed diabetes mellitus is high in most countries of sub-Saharan Africa, and individuals who are unaware they have the disorder are at very high risk of chronic complications. Therefore, the prevalence of diabetes-related morbidity and

Causes of amputation in sub-Saharan Africa vary between and within countries (Ephraim *et al.,* 2003, Thanni and Tade 2007) depending on ethnic background and socio-economic status (Leggetter *et al,* 2002, Rucker-Whitaker *et al.,* 2003). In sub-Saharan Africa, tumours and trauma are the leading causes of lower extremities amputation (Abbas and Musa, 2007, Thanni and Tade 2007), with increasing incidence of cardiovascular risk factors

In Kenya, rates of vascular amputations vary between 25% and 56% with Muyembe and Muhinga (1999) reporting that the leading indications of lower extremities amputation were trauma, tumours and complications of diabetes mellitus, each accounting for 26.5% of the amputations done. Another Kenya study recorded seven years later by Awori and Atinga, (2007) reported that 17.5% of patients who underwent amputation were due to diabetesrelated gangrene. Two years later in 2009, diabetic vasculopathy accounted for 11.4% of the amputations and 69.6% of the non vascular cases while other causes of amputation included: 35.7% trauma, 20% congenital defects, 14% infection and 12.8% tumours

**1. Introduction** 

mortality could grow substantially

respectively (Ogeng'o et al., 2009).

(Akinboboye et al., 2003).

**in Sub-Saharan Africa** 

*Kampala International University, Western Campus,* 

*1Department of Microbiology; 2Department of Internal Medicine;* 

*3Department of Anatomy* 

*Uganda* 
