Incidence of foot ulcers in patients with diabetes at a university hospital in Tokyo over a 5-year period

Abstract

There have been no reports about the incidence and etiologies of foot ulcers in Japanese patients with diabetes, and the best method to prevent foot ulcers remains unclear. We investigated the incidence and etiologies of foot ulcers in patients with diabetes at a university hospital in Tokyo over a 5-year period. Neuropathy, angiopathy, foot deformity, and history of foot ulcers were investigated in 578 diabetic patients from September 2007 to March 2008. Information on the development of foot ulcers between the day of the first survey and 1st October 2012 was obtained from medical records, and the incidence was calculated using Kaplan–Meier survival analysis. The mean age of the subjects was 65.4 ± 10.8 years and the mean duration of diabetes was 13.8 ± 9.3 years. During the study period, 153 subjects dropped out. Among the 6 subjects who developed foot ulcers, 4 were in category 0 in the Risk Categorization System of the International Consensus on the Diabetic Foot, 1 was in category 1, and 1 was in category 2. Three ulcers were due to burns, 3 ulcers were secondary to trauma, and 1 was due to deterioration of callus. The incidence of foot ulcers over a period of 60 months was 1.2 %. The incidence of foot ulcers in Japanese patients with diabetes was low. Of note, both high-risk and no-risk patients developed foot ulcers. Most cases were caused by burns or trauma. Education will be needed for all diabetic patients to prevent burns and trauma in Japan.