Can a combination of lifestyle and clinical characteristics explain the presence of foot ulcer in patients with diabetes?

• Published in: Journal of diabetes and its complications 2019-06, Vol.33 (6), p.437-444
• Main Authors: Naemi, Roozbeh, Chockalingam, Nachiappan, Lutale, Janet K., Abbas, Zulfiqarali G.
• Format: Article
• Language: English
• Subjects: Alcohol use; Amputation; Biomechanics; Cold; Diabetes; Diabetic foot; Diabetic neuropathy; Diagnosis; Foot diseases; Health risk assessment; Leg ulcers; Lifestyles; Medical diagnosis; Patients; Plantar soft tissue; Smoking; Vascular disease
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2019.02.006

The aim of this study was to identify the biomechanical, neurological and clinical parameters along with other demographics and lifestyle risk factors that could explain the presence of foot ulcer in patients with diabetes in Africa. A total of 1270 (M/F:696/574) patients; 77(M/F:53/24) with ulcerated vs 1193 (M/F: 643/550) with non-ulcerated feet; participated in this study. A set of 28 parameters were collected and compared between the participants with and without active foot ulcers. Multivariate logistic regression was utilised to develop an explanatory model for foot ulceration. Foot swelling (χ2(1,n = 1270) = 265.9,P = 0.000,Phi = 0.464) and impaired sensation to monofilament (χ2(2,n = 1270) = 114.2,P = 0.000,Cramer'sV = 0.300) showed strong association with presence of ulceration. A lower Temperature sensitivity to cold stimuli and limited ankle joint mobility were observed to be significant (P