531-P: Role of Social and Family Status in Long-Term Follow-up of Patients with Diabetic Foot

Patients and Methods: 396 patients were identified from 3 diabetic foot (DF) clinics with follow-up for 1 year (2019-2022). Patients constituted study groups according to their social status: living in family (Group 1, n=154), periodical care (Group 2, n=132), living alone (Group 3, n=110). We estimated quantity of patients with ulcers at time of primary visit, after 6 and 12 months.

Results: 202 (51%) patients were females, 194 (49%) males. Mean age was 59.2±2.7 years. Mean HbA1c was 8.7±1.7%. 56 (14%) patients had HbA1c < 7.0%, whereas 179 (45%) patients had HbA1c > 8.2%. We provided a “fear management strategy” to patients and relatives. However, emotional reaction of single patient was weak and sceptic. Reaction of patients’ relatives was productive with multiple questions. From Group2 on 2nd visit 28 relatives out of 35 came for the first time. At follow-up of 1 year, we detected decreasing of DF ulcers in Group1 from 16% to 10%. In Group2 increasing of ulcers frequency was increased up to 12% (13 patients with new ulcers, of which 11 patients admitted DF clinic alone). In Group3 was increasing ulcers frequency from 20% to 28.5%. 7 patients underwent amputations (5 low-amputations, 2 high-amputation): one patients in Group 1, 6 patients in Group3. Patients who were accompanied by relatives support at time of visit to DFclinic had decreasing of ulcers frequency (baseline-6 months-1 year) 17.4-36.2-18.8%, as compared to patients not-accompanied with relatives for 8-34-31%, respectively. After beginning of Russian aggression against Ukraine 2 DFclinic were closed, but 49 patients were still under the follow-up.

Conclusions: Living in family even under partial care is associated with better benefit for patients. Visit relatives together with patient to DF clinic scientifically improves effect of treatment. Alone patients have higher level of amputation and complications. War is associated with significant and negative impact on DF medical centers and quantity of patients who can possibility to admit clinic.