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Assessment of risk factors in diabetic foot ulceration and their impact on the outcome of the disease
Authors:Emad Naeem Hokkam
Institution:1. Diabetic Foot Clinic, Endocrinology, Diabetes and Metabolism Department - Centro Hospitalar de Vila Nova de Gaia/Espinho EPE, Vila Nova de Gaia, Portugal;2. Internal Medicine Department - Centro Hospitalar de Vila Nova de Gaia/Espinho EPE, Vila Nova de Gaia, Portugal;3. Biochemistry Department (U38-FCT)-Faculty of Medicine of the University of Porto, Oporto, Portugal;4. CIDES/CINTESIS (U753-FCT)-Health Information and Decision Sciences Department, Oporto Faculty of Medicine, Oporto, Portugal;5. Seattle Epidemiologic Research and Information Centre-Department of Veterans Affairs Puget Sound Health Care System and the University of Washington, Seattle, WA, USA;6. Health Sciences Faculty of the Fernando Pessoa’s University, Oporto, Portugal;7. Cancer Biology Group-Institute of Molecular Pathology and Immunology of the University of Porto, Oporto, Portugal, Faculty of Medicine of the University of Porto, Oporto, Portugal
Abstract:AimsThe current study aims to identify risk factors for diabetic foot ulcer and their impact on the outcome of the disease.MethodsThree hundred diabetic patients were enrolled in the study. One hundred eighty subjects with diabetic foot ulcer and 120 diabetic controls without foot lesions. All expected risk factors were studied in all patients and after a follow up period, patients with diabetic foot ulcer were classified into group A (patients with healed ulcers) and group B (patients with persistent ulcer or ended by amputation). The risk factors were reanalyzed in both groups to find out their impact on the outcome of the disease.ResultsThe following variables were significant factors for foot ulceration: Male gender (P = 0.009), previous foot ulcer (P = 0.003), peripheral vascular disease (P = 0.004), and peripheral neuropathy (P = 0.006). Also lack of frequent foot self-examination was independently related to foot ulcer risk. The outcome was related to longer diabetes duration (P = 0.004), poor glycaemic control (P = 0.006) and anaemia (P = 0.003) and presence of infection (P < 0.001).ConclusionsPeripheral vascular disease and peripheral neuropathy together with lack of foot self-examination, poor glycaemic control and anaemia are main significant risk factors for diabetic foot ulceration.
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