MARIA DEL PILAR FERNÁNDEZ FERNÁNDEZ¹, ANA MARIA LUCAS OCHOA², Sandra Amador³, ANA MARÍA GONZÁLEZ CUELLO³, Emiliano Fernández Villalba³, Valeria Raparelli⁴, Collen Norris⁵, Alexandra Kautzky-Willer⁶, Karolina Kublickiene⁷, Louis Pilote⁸, Maria Trinidad Herrero Ezquerro²

(1) Clinical and Experimental Neuroscience (NiCE-IMIB), Institute for Aging Research and Bio-Health Research of Murcia, School of Medicine, Campus Mare Nostrum, University of Murcia, Murcia, Spain, 04740, España (Andalucía)
(2) NEUROCIENCIA CLÍNICA Y EXPERIMENTAL, IMIB-Arrixaca, España
(3) Clinical and Experimental Neuroscience (NiCE-IMIB), Institute for Aging Research and Bio-Health Research of Murcia, School of Medicine, Campus Mare Nostrum, University of Murcia, Murcia, Spain, España (Región de Murcia)
(4) Department of Transnational Medicine University of Ferrara, Ferrara, Italy, Italia
(5) Faculty of Nursing University of Alberta, Edmonton, Alta, Cardiovascular and Stroke Strategic Clinical Network, Alberta Health Services, Edmonton, Alta, Canada, Canadá
(6) Division of Endocrinology and Metabolism Department of Medicine III, Medical University of Vienna, Vienna, Austria, Austria
(7) Department of Renal Medicine Institution for Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden, Suecia
(8) Research Institute of McGill University Health Centre Division of Clinical Epidemiology McGill University, Montreal, Canada, Canadá

The chronic hyperglycemia of diabetes is associated with multiple damages, as well as chronic complications such as foot ulcers and amputations. Male gender is associated with an increased risk of diabetic foot amputations. The intervals from 60 to 64 years, or from 50 to 69 are the age groups most affected. There are also marked differences in the epidemiology of diabetes between different ethnic groups, the result of complex interactions between sociodemography, inherited characteristics, and lifestyle. Likewise, the collection of anthropometric data (physical condition) and biochemical tests (glucose, HbA1c, etc.) are essential in exploring the mechanism of diabetes melliltus and its development. The aim of this study was to evaluate, with a gender perspective, the clinical, sociodemographic, and cultural factors of diabetic older adults with skin lesions, to know the predictive factors that affect the appearance and evolution of ulcers to establish preventive measures.

Retrospective descriptive study. 200 medical records of diabetic adults over 60 years of age, with skin lesions in the last 10 years, were recruited from the Almeria population belonging to the “Cruz de Caravaca” health centre. These clinical records were dissociated with a numerical code and the proposed variables were collected. The relationship of the variables was analyzed with Machine Learning techniques. The results were interpreted based on the decision trees obtained.

Women have less toxic habits and men worse physical conditions. Male gender has up to 3.5 times the risk of diabetic foot amputations. Ethnicity and nationality were not representative, as 97% were Caucasian and 98% Spanish. Chronic diabetic foot wounds only constituted 6% of the sample, and could be related to a risk factor between the ages of 60 and 85 years. The most used treatments were nonsurgical sharp debridement, enzymatic debridement, Ag dressings, and the use of oral antibiotic therapy, with scientific evidence turning mainly to the use of Ag dressings. The consumption of tobacco and alcohol are risk factors for each other. Renal pathology has an important relationship with changes in the healing time of skin lesions. Hipertension has been related to areas of residence of the elderly population and dyslipidaemia. Amputations with dyslipidaemia and Covid-19 with ages over 80 years. Diabetes education has had high percentages.

Diabetes education, which includes diabetic foot screening and the provision of resources, is the essential axis for avoiding complications derived from DM.