Clinical characteristics of patients with diabetic foot problems: changing patterns of foot ulcer presentation

Abstract

AbstractAimsPatients with diabetic foot complications vary demographically and invariably have other co‐morbidities that affect quality of life. The aim of this study was to identify some clinical characteristics of such patients and to reveal any changes over the recent decades.MethodsCase notes of patients referred to the Manchester Diabetic Foot Clinic during a 7 year period were examined. Patient demographics, referral source and reason for referral, previous amputations, and diabetes complications at presentation were recorded.Results298 patients (185 males) newly attended the foot clinic during the 7 year period (1990–1996). Mean ± SD age and duration of diabetes was 62.5 ± 13.1 and 14.9 ± 11.6 years, respectively. Most patients (73.3%) had type 2 diabetes and 86.7% attended because of foot ulceration. Ulcers were mainly neuroischaemic (52.3%) and located on the forefoot (76.7%). Eighty per cent of patients had clinical evidence of peripheral neuropathy, 60% had peripheral arterial disease (only a third of whom were symptomatic) and 70% had multiple diabetic complications. Hypertension (48.1% versus 32.1%, p = 0.007) and previous amputation (15.2% versus 5.4%, p = 0.01) were commoner in males. Females had a greater prevalence of multiple foot ulcers (21.5% versus 12.7%, p = 0.03), compared with males.ConclusionPatients with diabetic foot ulcers have multiple diabetic complications and tend to have predominantly neuroischaemic ulcers. These clinical characteristics are bound to have significant impact on treatment costs and mortality in such patients. Copyright © 2002 John Wiley & Sons, Ltd.