Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 15;24(1):46.
doi: 10.1186/s12902-024-01572-x.

Two-year incidence and risk factors of diabetic foot ulcer: second phase report of Ahvaz diabetic foot cohort (ADFC) study

Leila Yazdanpanah  1 , Hajieh Shahbazian  2 , Saeed Hesam  3 , Behnam Ahmadi  4 , Amir Mohammad Zamani  4
Affiliations

Two-year incidence and risk factors of diabetic foot ulcer: second phase report of Ahvaz diabetic foot cohort (ADFC) study

Leila Yazdanpanah et al. BMC Endocr Disord. .

Abstract

Aim/introduction: This study was designed as the second phase of a prospective cohort study to evaluate the incidence and risk factors of diabetic foot ulcers (DFU).

Materials and methods: The study was conducted in a university hospital in Iran. Each participant was checked and followed up for two years in terms of developing newfound DFU as ultimate outcome. We investigated the variables using univariate analysis and then by backward elimination multiple logistic regression.

Results: We followed up 901 eligible patients with diabetes for two years. The mean age of the participants was 53.24 ± 11.46 years, and 58.53% of them were female. The two-year cumulative incidence of diabetic foot ulcer was 8% (95% CI 0.071, 0.089) [Incidence rate: 49.9 /1000 person-years]. However, the second-year incidence which was coincident with the COVID-19 pandemic was higher than the first-year incidence (4.18% and 1.8%, respectively). Based on our analysis, the following variables were the main risk factors for DFU incidence: former history of DFU or amputation [OR = 76.5, 95% CI(33.45,174.97), P value < 0.001], ill-fitting foot-wear [OR = 10.38, 95% CI(4.47,24.12), P value < 0.001], smoking [OR = 3.87,95%CI(1.28, 11.71),P value = 0.016], lack of preventive foot care [OR = 2.91%CI(1.02,8.29),P value = 0.045], and insufficient physical activity[OR = 2.25,95% CI(0.95,5.35),P value = 0.066].

Conclusion: Overall, the two-year cumulative incidence of diabetic foot ulcer was 8% [Incidence rate: 49.9 /1000 person-years]; however, the second-year incidence was higher than the first-year incidence which was coincident with the COVID-19 pandemic (4.18% and 1.8%, respectively). Independent risk factors of DFU occurrence were prior history of DFU or amputation, ill-fitting footwear, smoking, lack of preventive foot care, and insufficient physical activity.

Keywords: DFU; Diabetic foot ulcer; Incidence; Risk factors.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Diagram of the participants of the second phase of ADFC
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Laclé A, Valero-Juan LF. Diabetes-related lower-extremity amputation incidence and risk factors: a prospective seven-year study in Costa Rica. Revista Panam De Salud Pública. 2012;32(3):192–8. doi: 10.1590/S1020-49892012000900004. - DOI - PubMed
    1. Martins-Mendes D, Monteiro-Soares M, Boyko EJ, Ribeiro M, Barata P, Lima J, et al. The independent contribution of diabetic foot ulcer on lower extremity amputation and mortality risk. J Diabetes Complicat. 2014;28(5):632–8. doi: 10.1016/j.jdiacomp.2014.04.011. - DOI - PMC - PubMed
    1. Lavary L, Armstrong D, Wunderlich R, Terdwell J, Boulton A. Evaluation the prevalence and incidence of foot pathology in mexican-americans and nonhispanic whites from a diabetes disease management cohort. Diabetes Care. 2003;23:1435–8. - PubMed
    1. Smith-Strøm H, Iversen MM, Igland J, Østbye T, Graue M, Skeie S, et al. Severity and duration of diabetic foot ulcer (DFU) before seeking care as predictors of healing time: a retrospective cohort study. PLoS ONE. 2017;12(5):e0177176. doi: 10.1371/journal.pone.0177176. - DOI - PMC - PubMed
    1. Fawzy MS, Alshammari MA, Alruwaili AA, Alanazi RT, Alharbi JA, Almasoud AMR, et al. Factors associated with diabetic foot among type 2 diabetes in Northern area of Saudi Arabia: a descriptive study. BMC Res Notes. 2019;12(1):1–7. doi: 10.1186/s13104-019-4088-4. - DOI - PMC - PubMed