Diabetes-related foot ulcers; what are the risk factors?

The authors aimed to identify the prevalence of diabetic foot ulcers and the associated risk factors in diabetic patients.

Diabetic patients can develop foot ulcers, which may be prone to infection. A skin ulcer is where an area of the skin has broken down, revealing the underlying tissue. While often easily and effectively treated, people with diabetes are at higher risk of infection and therefore it becomes important to identify risk factors for this condition.

The authors aimed to determine the proportion of people with type 1 and type 2 diabetes reporting a history of foot ulcer, and to investigate factors associated with foot ulcers and healing time. The study included 1,751 patients with diabetes who responded to a health survey questionnaire.

7.4% of the patients reported a history of foot ulcer requiring more than 3 weeks to heal, with an average healing time of 6 weeks.

Compared to those < 75 years, those > 75 years were 2.3 times more likely to have a history of foot ulcer. Compared to women, men were twice as likely to have a history of foot ulcer. Men with a waist circumference ≥ 102 cm and women with a waist circumference ≥ 88 cm were 95% more likely to have a history of foot ulcer. Those taking insulin were 2.1 times more likely to have a history of foot ulcer while those with macrovascular complications (blood vessel disorders, such as coronary artery disease, peripheral arterial disease etc.) were 80% more likely to have a history of foot ulcer.

The authors concluded that, in diabetic patients, older age, male sex, greater waist circumference, insulin medication and macrovascular complications were risk factors for diabetic foot ulcers.

Due to the design of the study, conclusions cannot be drawn about whether these risk factors are a direct cause of diabetic foot ulcers.

Diabetic patients are encouraged to practice good foot care, and have their feet examined by a doctor where appropriate.