Presenter of 2 Presentations
CONSEQUENCES OF SUBOPTIMAL METABOLIC CONTROL ON THE EVOLUTION OF DIABETIC FOOT PATHOLOGY IN TYPE 2 DIABETES MELLITUS
Abstract
Abstract Body
Background and purpose
Diabetic foot pathology (DFP) is one of the most common consequences of metabolic decontrol in type 2 Diabetes Mellitus (T2DM). The treatment is based on the management of the diabetic pathology following healthy habits to ensure metabolic control and checking periodically diabetic foot sensitiveness to detect neurovascular pathology.
Methods
Describe the consequences of suboptimal metabolic control on DFP based on a clinical case with photo report of a 66-year-old patient with pathological background including: T2DM, HTA, obesity and smoking.
Results
The patient arrived in June 2018 to our Primary Health Centre (PHC) with a recent right fifth toe amputation and a bad metabolic control (9.4% Glycated Hemoglobin (HbA1c)). He managed to reduce his HbA1c until 6.2% in September 2018 following our T2DM control guidelines. During the first months of 2020 his adherence to healthy habits declined. By March, his HbA1c increased to 9.8% and consequently suffered a DFP worsening; a new diabetic foot ulcer appeared which needed a first toe amputation. In June 2020, the patient improved his metabolic control, reducing HbA1c values to 7.6%. However, six months later his HbA1c increased again to 9.7% and the DFP worsened requiring a transmetatarsal amputation.
Conclusions
While the patient had an optimal metabolic control, the progression of his DFP diminished. However, as soon as the patient changed his healthy lifestyle, his DFP suffered a significant worsening. Unhealthy habits, therefore, metabolic decontrol have a direct consequence on DFP deterioration.
AGE OF MORTALITY AND MORTALITY RISK-FACTORS ASSOCIATED TO HOMELESSNESS IN CATALONIA (SPAIN)
Abstract
Abstract Body
Background and purpose
Homelessness is a situation of severe social exclusion that affects all areas of individuals experiencing it.
Methods
A transversal, observational and analytic study was conducted. During 2016 and 2020 the research team formed by different public health and public services recruited the information of the participants. The services were: a primary health center, a drug addiction public center and a public shelter for individuals experiencing homelessness (IEH). Data collected included: dead/alive status, age of death and differences between death ages in relation to some sociodemographic characteristics. The ethics committee CEI-Girona previously approved in 2016 the research protocol the study followed.
Results
3854 IEH were included in the study. The 85.4% were men (n = 3292) and the 60.4% of the sample were foreign born IEH (n = 2328). 391 IEH died during the study (13.2%). The average age of death was 52.4 years old (ED = 13.2). Causes of death included: suicide (n = 92, 24.1%), hepatic cirrhosis (n = 10, 18.3%), overdose (n = 58, 15.2%), heart disease/attack (n = 42, 11.0%), AIDS (n = 36, 9.4%), chronic obstructive pulmonary disease exacerbation (n = 36, 9.4%), cancer (n = 31, 7.9%) and meningitis (n = 18, 4.7%).
Conclusion
IEH have a lower life expectancy than general population. It is important to design specific programs to detect and treat social exclusion parameters related to health, social exclusion and mortality of IEH.