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

Naemi, Roozbeh; Chockalingam, Nachiappan; Lutale, Janet K.; Abbas, Zulfiqarali G.

Abstract

Aims
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.

Methods
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.

Results
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 < 0.05) contributors to ulceration. The logistic regression model can justify the presence of foot ulceration with 95.3% diagnostic accuracy, 99.1% specificity and 37.3% sensitivity.

Conclusion
Participants with ulcerated foot show distinct characteristics in few foot related parameters. Swollen foot, limited ankle mobility, and peripheral sensory neuropathy were significant characteristics of patients with diabetic foot ulcer. One out of three patients with ulcerated foot showed common characteristics that could be justified by the model.

Citation

Naemi, R., Chockalingam, N., Lutale, J. K., & Abbas, Z. G. (2019). Can a combination of lifestyle and clinical characteristics explain the presence of foot ulcer in patients with diabetes?. Journal of Diabetes and its Complications, 33(6), 437-444. https://doi.org/10.1016/j.jdiacomp.2019.02.006

• Journal Article Type: Article
• Online Publication Date: May 8, 2019
• Publication Date: 2019-06
• Deposit Date: Apr 14, 2024
• Journal: Journal of Diabetes and its Complications
• Print ISSN: 1056-8727
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 33
• Issue: 6
• Pages: 437-444
• DOI: https://doi.org/10.1016/j.jdiacomp.2019.02.006