Prevalence of Factors Predisposing to Foot Complication
and Their Relation to Other Risks
Charnvate Sattaputh MD*,
Somkiat Potisat MD**, Amporn Jongsareejit MD***,
Udom Krairittichai MD****, Kunakorn Pooreesathian MD*
Affiliation :
* Department of Surgery, Lerdsin Hospital, Ministry of Public Health, Bangkok, Thailand
** Institute of Medical Research and Technology Assessment, Department of Medical Services, MOPH, Nonthaburi, Thailand
*** Prasat Neurological Institute, Department of Medical Services, MOPH, Bangkok, Thailand
**** Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
Background : Diabetic neuropathy and peripheral vascular disease (PVD) have been identified as major risk factors for
diabetic foot ulceration and amputation in patients with type 2 diabetes mellitus (T2DM) but in Thailand have been a few
of prospective studied about the prevalence and risk factors of diabetic neuropathy and PVD.
Objective : To evaluate the prevalence of diabetic neuropathy and PVD in Thai patients with T2DM and to determine other
factors that related with them.
Material and Method: A cross-sectional study of 899 Thai T2DM patients from the out-patient department of seven public
hospitals in Thailand between January 2007 and September 2008 was performed. Histories of these patients, complete
physical examinations, feet examination, and blood with urine chemistry were obtained.
Results : Most of the patients were females with the average age of 59.64 years, the average of body mass index (BMI) was
27.32 kg/m2, the average duration of diabetes was 8.12 years and 85.17% of patients were HbA1C ≥ 7%. Diabetic patients
with PVD group compared with no PVD group, there were statistically significant differences for duration of having diabetes
(OR 1.08; 95% CI [1.01-1.16]; p-value 0.047), creatinine level (OR 1.62; 95% CI [1.12-2.33]; p-value 0.01), present
diabetic neuropathy (OR, 7.37; 95% CI [2.52-21.59]; p-value < 0.001). Patients with diabetic neuropathy group compared
with no diabetic neuropathy group, there were statistically significant differences of age (OR, 1.04; 95% CI [1.01-1.06];
p-value 0.003), duration of having diabetes (OR, 1.04; 95% CI [1.01-1.07]; p-value 0.008), on ACEI or ARB drug (OR,
1.77; 95% CI [1.24-2.55]; p-value 0.002), HbA1C (OR, 1.14; 95% CI [1.03-1.27]; p-value 0.012), creatinine level (OR,
1.38; 95% CI [1.04-1.79]; p-value 0.014), present diabetic retinopathy (OR, 1.96; 95% CI [1.22-3.13]; p-value 0.005),
present PVD (OR, 7.37; 95% CI [2.52-21.59]; p-value < 0.001), present diabetic nephropathy with microalbuminuria (OR,
1.74; 95% CI [1.12-2.69]; p-value 0.013).
Conclusion : Two percent of T2DM patients had PVD that associated with duration of diabetes, creatinine level, and diabetic
neuropathy and 15% of T2DM patients had diabetic neuropathy that depended on age, duration of having diabetes, on
ACEI or ARB drug, creatinine level, HbA1C, diabetic retinopathy, diabetic nephropathy, and PVD.
Keywords : Diabetic foot, Diabetes mellitus
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