Diabetic Foot Ulcer Risk in Adults with Type 2 Diabetes Mellitus: A Cross-Sectional Study
DOI:
https://doi.org/10.36570/jduhs.2024.1.2015Keywords:
Diabetic Foot, Foot Ulcer, Type 2 Diabetes Mellitus , Noninsulin-Dependent Diabetes MellitusAbstract
Objective: To determine the prevelance and factors associated with diabetic foot ulcer risk (DFU) in adults with type 2 diabetes mellitus (T2DM) patients.
Methods: This cross-sectionale study was conducted in the rural and urban areas in the South Sulawesi Province, Indonesia, from April to December 2022. The study included people diagnosed with T2DM for atleast one year, aged 18-60 years. The outcome of the study was DFU risk among people diagnosed with T2DM, which was measured using the screening for the High-Risk Diabetic Foot 60-Second Tool and Ipswich Touch Test (IpTT).
Results: Of total 361 T2DM patients, the mean age was 53.8 ± 5.8 years. There were 118 (32.7%) males and 243 (67.3%) females. Overall risk of DFU was observed in 110 (30.5%) patients. A significant association of DFU risk found with gender (p-value 0.007), education (p-value <0.001), occupation (p-value 0.033), ethnicity (p-value 0.039), and diabetes complications (p-value <0.001). Females were 0.48 times less likely at risk of diabetic foot ulcer as compared to males (cOR 0.52, 95% CI 0.33 to 0.84, p-value 0.007). There was 0.62 times less risk of diabetic foot ulcer in patients who had no diabetes complications as compared to patients with diabetes
complications (cOR 0.38, 95% CI 0.22 to 0.65, p-value <0.001).
Conclusion: The study highlighted a notable prevalence of DFU in T2DM patients. Gender, education, occupation, ethnicity, and diabetes complications emerged as key factors influencing DFU risk. Moreover, females and patients without diabetes complications had significantly lower DFU risk
Downloads
References
Dogruel H, Aydemir M, Balci MK. Management of diabetic foot ulcers and the challenging points: An endocrine
view. World J Diabetes 2022; 13:27-36. doi:10.4239/wjd.v13.i1.27
Chen L, Sun S, Gao Y, Ran X. Global mortality of diabetic foot ulcer: A systematic review and meta-analysis of observational studies. Diabetes Obes Metab 2023; 25:36–45. doi:org/10.1111/dom.14840
Schaper NC, van Netten JJ, Apelqvist J, Bus SA, Hinchliffe 1. RJ, Lipsky BA, et al. Practical guidelines on the prevention and management of diabetic foot disease (IWGDF 2019 update). Diabetes Metab Res Rev 2020;
:e3266. doi:org/10.1002/dmrr.3266
Bus SA, Waaijman R, Arts M, de Haart M, BuschWestbroek T, van Baal J, et al. Effect of custom-made footwear on foot ulcer recurrence in diabetes: a multicenter randomized controlled trial. Diabetes Care 2013; 36:4109–16. doi:org/10.2337/dc13-0996
Sattar N. Advances in the clinical management of type 2 diabetes: a brief history of the past 15 years and challenges for the future. BMC Med 2019; 17:1–4 doi:org/10.1186/s12916-019-1281-1
Hingorani A, LaMuraglia GM, Henke P, Meissner MH, Loretz L, Zinszer KM, et al. The management of diabetic foot: a clinical practice guideline by the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for
Vascular Medicine. J Vasc Surg 2016; 63:3S-21S. doi:org/10.1016/j.jvs.2015.10.003
Chun D, Kim S, Kim J, Yang H-J, Kim JH, Cho J, et al. Epidemiology and burden of diabetic foot ulcer and peripheral arterial disease in Korea. J Clin Med 2019; 8:748. doi:org/10.3390/jcm8050748
Raghav A, Khan ZA, Labala RK, Ahmad J, Noor S, Mishra BK. Financial burden of diabetic foot ulcers to world: a progressive topic to discuss always. Ther Adv Endocrinol Metab 2018; 9:29-31. doi:org/10.1177/2042018817744513
Al-Mohaithef M, Abdelmohsen SA, Algameel M, Abdelwahed AY. Screening for identification of patients at high risk for diabetes-related foot ulcers: a crosssectional study. J Int Med Res 2022; 50:30006052210 87815. doi:org/10.1177/03000605221087815
Sutherland BL, Pecanac K, Bartels CM, Brennan MB. Expect delays: poor connections between rural and
urban health systems challenge multidisciplinary care for rural Americans with diabetic foot ulcers. J Foot Ankle Res 2020; 13:32.
doi:org/10.1186/s13047-020-00395-y
Brennan MB, Powell WR, Kaiksow F, Kramer J, Liu Y, Kind AJH, et al. Association of Race, Ethnicity, and Rurality With Major Leg Amputation or Death Among Medicare Beneficiaries Hospitalized With Diabetic Foot Ulcers. JAMA Netw Open 2022; 5: e228399.
doi:org/10.1001/jamanetworkopen.2022.8399
Sibbald RG, Ayello EA, Alavi A, Ostrow B, Lowe J, Botros M, et al. Screening for the high-risk diabetic foot: a 60-second tool (2012). Adv Skin Wound Care 2012; 25:465–8. doi:org/10.1097/01.asw.0000421460.21773.7b
Rayman G, Vas PR, Baker N, Taylor CGJ, Gooday C, Alder AI, et al. The Ipswich Touch Test: a simple and novel method to identify inpatients with diabetes at risk of foot ulceration. Diabetes Care 2011; 34:1517–8. doi:org/10.2337/dc11-0156
Boyko EJ, Ahroni JH, Cohen V, Nelson KM, Heagerty PJ. Prediction of diabetic foot ulcer occurrence using commonly available clinical information: the Seattle Diabetic Foot Study. Diabetes Care 2006; 29:1202-7. doi:org/10.2337/dc05-2031
Monteiro-Soares M, Boyko EJ, Ribeiro J, Ribeiro I, DinisRibeiro M. Risk stratification systems for diabetic foot ulcers: a systematic review. Diabetologia 2011; 54:1190- 9. doi:org/10.1007/s00125-010-2030-3
Smith-Strom H, Iversen MM, Igland J, Ostbye T, Graue M, Skeie S, et al. Severity and duration of diabetic foot ulcer (DFU) before seeking care as predictors of healing time: a retrospective cohort study. PLoS One 2017; 12:e0177176. doi:org/10.1371/journal.pone.0177176
Rossboth S, Lechleitner M, Oberaigner W. Risk factors for diabetic foot complications in type 2 diabetes-A systematic review. Endocrinol diabetes Metab J 2021; 4:e00175. doi:org/10.1002%2Fedm2.175
Vanherwegen AS, Lauwers P, Lavens A, Doggen K, Dirinck E. Initiative for Quality Improvement and Epidemiology in ultidisciplinary Diabetic Foot Clinics (IQED-Foot) Study Group. Sex differences in diabetic foot ulcer severity and outcome in Belgium. PLoS One
; 18:e0281886. doi: 10.1371/journal
Collins J, Abbass IM, Harvey R, Suehs B, Uribe C, Bouchard J, et al. Predictors of all-cause 30 day readmission among Medicare patients with type 2 diabetes. Curr Med Res Opin 2017; 33:1517-23. doi:org/10.1080/03007995.2017.1330258
Oliver TI, Mutluoglu M. Diabetic Foot Ulcer. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537328/
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; 49:106-16. doi:10.1080/07853890.2016.1231932
Hirpa D, Bekela T, Abdissa D. Prevalence of diabetic foot ulcer and its associated factors among diabetes patients on follow up at public hospitals in West Shewa Zone, Oromia, Ethiopia. Int J Africa Nurs Sci 2023; 19:100578. doi:org/10.1016/j.ijans.2023.100578
Gershater MA, Apelqvist J. Elderly individuals with diabetes and foot ulcer have a probability for healing despite extensive comorbidity and dependency. Expert Rev Pharmacoecon Outcomes Res 2021; 21:277 -84. doi:org/10.1080/14737167.2020.1773804
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Yusran Haskas, Hadi prayitno, Suarnianti Suarnianti
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Articles published in the Journal of Dow University of Health Sciences are distributed under the terms of the Creative Commons Attribution Non-Commercial License https://creativecommons.org/ licenses/by-nc/4.0/. This license permits use, distribution and reproduction in any medium; provided the original work is properly cited and initial publication in this journal.