Amputation and infection are the greatest fears in patients with diabetes foot complications

• Published in: Journal of diabetes and its complications 2022-07, Vol.36 (7), p.108222-108222, Article 108222
• Main Authors: Wukich, Dane K., Raspovic, Katherine M., Jupiter, Daniel C., Heineman, Nathan, Ahn, Junho, Johnson, Matthew J., Liu, George T., VanPelt, Michael D., Lafontaine, Javier, Lavery, Larry, Kim, Paul, Nakonezny, Paul A.
• Format: Article
• Language: English
• Subjects: Amputation; Ankle; Cardiovascular disease; Complications; Diabetes; Diabetic retinopathy; Fear; Fear & phobias; Foot; Foot diseases; Heart attacks; Hemodialysis; Hemoglobin; Hypoglycemia; Infection; Infections; Kidney diseases; Leg ulcers; Likert scale; Mortality; Patients; Statistical analysis; Stroke
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2022.108222

To determine the degree patients with diabetic foot ulcers, Charcot neuroarthropathy and neuropathic fractures and dislocations fear complications (death, dialysis, heart attack, stroke, blindness, diabetic foot infection, minor and major lower extremity amputation [LEA]) that can occur and to assess if there is a difference between fears of patients with diabetic foot ulcers, Charcot neuroarthropathy and neuropathic fractures and dislocations and diabetic patients without these complications. 478 patients completed an eight question Likert scale survey. The study group was defined as non-infected foot ulcers, neuropathic fractures and Charcot neuroarthropathy. Of the 478 patients, 121 (25.3 %) had diabetic foot ulcers, Charcot neuroarthropathy or neuropathic fractures and dislocations and 357 (74.7 %) did not. The study group had significantly higher odds of reporting extreme fear of foot infection (OR 2.8, 95 % CI 1.8–4.5), major LEA (OR 2.8, 95 % CI 1.8–4.4), minor LEA (OR 2.3, 95 % CI 1.5–3.5), blindness (OR 2.0, 95 % CI 1.3–3.2), dialysis (OR 2.0, 95 % CI 1.1–3.3), and death (OR 2.4, 95 % CI 1.4–4.2). In the study group highest rated fear measures were foot infection (3.71, SD 1.23), minor amputation (3.67, SD 1.45) and major amputation (3.63, SD 1.52). There were no significant differences in the mean fear of infection, minor amputation or major amputation. Patients with diabetic foot ulcers, Charcot neuroarthropathy or neuropathic fractures and dislocations reported higher fear ratings of diabetes-related complications compared to those without these complications. •Foot infection is feared more than death, blindness, heart attack, stroke or dialysis•Minor lower extremity amputation is feared more than death, blindness, heart attack, stroke or dialysis•Major lower extremity amputation is feared more than death, blindness, heart attack, stroke or dialysis•There is no difference in the fear of infection, minor amputation or major amputation