Associations between diabetes-related foot disease, diabetes, and age-related complications in older patients

• Published in: European geriatric medicine 2021-10, Vol.12 (5), p.1003-1009
• Main Authors: Sable-Morita, Sayuri, Okura, Mika, Tanikawa, Takahisa, Kawashima, Syuji, Tokuda, Haruhiko, Arai, Hidenori
• Format: Article
• Language: English
• Subjects: Aged; Diabetes Mellitus, Type 2; Diabetic Neuropathies; Foot Diseases; Geriatrics/Gerontology; Humans; Hypertension - complications; Internal Medicine; Medicine; Medicine & Public Health; Outpatients; Research Paper
• ISSN: 1878-7649; 1878-7657; 1878-7657
• DOI: 10.1007/s41999-021-00491-7

Key summary points Aim To evaluate the association between diabetes-related foot disease and diabetes-related complications in older patients with diabetes mellitus. Finding We found that hypertension, diabetes-related peripheral neuropathy, and grip strength were significantly associated with diabetes-related foot disease in older patients with diabetes mellitus. Additionally, the combination of diabetes-related peripheral neuropathy and hypertension further increased the risk of diabetes-related foot disease in comparison with either of the two independently. Messages Patients presenting with a history of the aforementioned complications should have their feet examined at an early stage and engage in preventative measures against severe diabetes-related foot disease. Purpose To examine the relationship of diabetes-related foot disease (DFD) with diabetes and age-related complications in older patients with diabetes mellitus (DM). Methods We examined 562 outpatients with diabetes, aged ≥ 65 years, for DFD. The variables collected in this study were demographics, DM-related complications, treatment method, and age-related complications. Differences in the complications were compared between patients with and without DFD. Logistic regression analysis was used to determine the associations of DFD with DM and age-related complications. Results A total of 246 patients (43.8%) had DFD. Logistic regression analysis identified low grip strength [Odds ratio (OR): 1.83, 95% confidence interval (CI) 1.21–2.76), hypertension (OR: 1.81, 95% CI 1.09–3.00), and diabetes-related peripheral neuropathy (DPN) (OR: 1.92, 95% CI 1.24–2.98) to be significantly associated with DFD. Patients with DPN and hypertension had a higher risk of DFD than patients with DPN or hypertension alone. Individuals with DPN and low grip strength (OR: 1.74, 95% CI 1.09–2.81) were at a lower risk than those with low grip strength alone. Conclusion Hypertension, DPN, and low grip strength were significantly associated with DFD in older patients with DM, with the risk of DFD being higher in patients with both DPN and hypertension. When considering DFD in older patients with DM, low grip strength should be considered equally important as a DM-related complication.