Prevalence, risk level and risk factors of diabetic foot ulcer among adult individuals with diabetes in the Southeastern Anatolia Region of Turkiye

Abstract

Objective: The aim of the study was to determine the prevalence, risk, and predisposing factors of diabetic foot ulcers in adults with diabetes.

Methods: This study is multi-centered descriptive cross-sectional research. Data were collected between June 2022 and November 2022 in seven cities, including five teaching and research hospitals and two public hospitals. The study included 357 people with diabetes. The sample was selected using stratified and systematic sampling. General demographic characteristics, medical history, laboratory and foot examination results, history of foot ulcer and/or amputation, skin and nail problems, peripheral sensory loss (10 g-Semmes-Weinstein monofilament) and vascular assessment were obtained. Logistic regression analysis was used to screen for factors affecting the diabetic foot.

Results: The prevalence of diabetic foot ulcers was 17.1 % (%13.2-%21.5; %95 CI). Among 296 individuals with diabetes without foot ulcers, 86.5 % (256) had risk level 0, 7.3 % (26) had risk level 1, 3.4 % (10) had risk level 2, and 1.4 % (4) had risk level 3. In regression analysis, the variables of peripheral arterial disease (Exp β: 3.781 - P = .027), history of ulcer (Exp β = 26,180 - P < .001), edema (Exp β: 9.784 - P < .001), fungus between the toes (Exp β = 5.284 - p = .009) were associated with a significantly increased risk of developing diabetic foot.

Conclusion: The prevalence of diabetic foot ulcers was found to be approximately two out of every 10 patients with diabetes, and peripheral arterial disease, history of ulcers, edema, and presence of fungus between the toes were found to be among the risks predicting diabetic foot. All diabetic individuals should be diagnosed in terms of diabetic foot risk factors, and follow-up and treatment should be planned considering the basic building blocks of diabetic foot prevention according to the determined risk group.

Keywords: Diabetic foot; Diabetic foot risk factor; Risk assessment; Risk level.