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Observational Study
. 2015 May 6;10(5):e0124446.
doi: 10.1371/journal.pone.0124446. eCollection 2015.

Diabetic foot complications and their risk factors from a large retrospective cohort study

Khalid Al-Rubeaan  1 , Mohammad Al Derwish  2 , Samir Ouizi  2 , Amira M Youssef  3 , Shazia N Subhani  4 , Heba M Ibrahim  3 , Bader N Alamri  5
Affiliations
Observational Study

Diabetic foot complications and their risk factors from a large retrospective cohort study

Khalid Al-Rubeaan et al. PLoS One. .

Abstract

Background: Foot complications are considered to be a serious consequence of diabetes mellitus, posing a major medical and economical threat. Identifying the extent of this problem and its risk factors will enable health providers to set up better prevention programs. Saudi National Diabetes Registry (SNDR), being a large database source, would be the best tool to evaluate this problem.

Methods: This is a cross-sectional study of a cohort of 62,681 patients aged ≥ 25 years from SNDR database, selected for studying foot complications associated with diabetes and related risk factors.

Results: The overall prevalence of diabetic foot complications was 3.3% with 95% confidence interval (95% CI) of (3.16%-3.44%), whilst the prevalences of foot ulcer, gangrene, and amputations were 2.05% (1.94%-2.16%), 0.19% (0.16%-0.22%), and 1.06% (0.98%-1.14%), respectively. The prevalence of foot complications increased with age and diabetes duration predominantly amongst the male patients. Diabetic foot is more commonly seen among type 2 patients, although it is more prevalent among type 1 diabetic patients. The Univariate analysis showed Charcot joints, peripheral vascular disease (PVD), neuropathy, diabetes duration ≥ 10 years, insulin use, retinopathy, nephropathy, age ≥ 45 years, cerebral vascular disease (CVD), poor glycemic control, coronary artery disease (CAD), male gender, smoking, and hypertension to be significant risk factors with odds ratio and 95% CI at 42.53 (18.16-99.62), 14.47 (8.99-23.31), 12.06 (10.54-13.80), 7.22 (6.10-8.55), 4.69 (4.28-5.14), 4.45 (4.05-4.89), 2.88 (2.43-3.40), 2.81 (2.31-3.43), 2.24 (1.98-2.45), 2.02 (1.84-2.22), 1.54 (1.29-1.83), and 1.51 (1.38-1.65), respectively.

Conclusions: Risk factors for diabetic foot complications are highly prevalent; they have put these complications at a higher rate and warrant primary and secondary prevention programs to minimize morbidity and mortality in addition to economic impact of the complications. Other measurements, such as decompression of lower extremity nerves, should be considered among diabetic patients.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Classification of diabetic patients sample from Saudi National Diabetes Registry (SNDR) aged ≥25 years according to diabetic foot status.
Fig 2
Fig 2. Effect of different diabetes chronic complications and types of vasculopathy on foot ulcer, gangrene, and amputation prevalence.
Fig 3
Fig 3. Age specific prevalence of diabetic foot disorders by gender for the total studied cohort of 62,681 diabetic patients.
See this image and copyright information in PMC

References

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