Risk Factors Of Diabetic Foot Research Articles

Risk Factors of Diabetic Foot among Patients in Al-Hilla Teaching Hospitals

Risk Factors of Diabetic Foot among Patients in Al-Hilla Teaching Hospitals

Review of the role of cigarette smoking in diabetic foot.

Diabetic foot ulceration has been a serious issue over the past decades in Asia, causing economic and social problems. Therefore, it is important to identify and reduce the risk factors of diabetic foot. Cigarette smoking has been reported to be associated with diabetes and its macrovascular complications, but the relationship between smoking and diabetic foot ulcers is still unclear. In the present review, we summarize the effects of cigarette smoking on diabetic foot ulcers with respect to peripheral neuropathy, vascular alterations and wound healing. One underlying mechanism of these impacts might be the smoking‐induced oxidative stress inside the cells. At the end of this review, the current mainstream therapies for smoking cessation are also outlined. We believe that it is urgent for all diabetic patients to quit smoking so as to reduce their chances of developing foot ulcers and to improve the prognosis of diabetic foot ulcers.

Prevalence and Risk Factors of Diabetic Septic Foot among Attendees of Diabetes Center of Arar City, Northern Saudi Arabia

Background: Diabetic septic foot contributes significantly to morbidity and mortality of patients with diabetes leading to substantial physical, physiological and financial burden for the patients and community at large. Objective: to determine the prevalence, patterns and risk factors of diabetic foot ulcers amongst patients with diabetes mellitus who were attending the diabetes center of Arar city in the period of the study. Methods: This was a retrospective study in the patients of the diabetes center of Arar city, Northern Saudi Arabia. The study was carried out during the period from 1 April to 31 May, 2018. All the patients attended the diabetes center in the period of the study were included in our data. The data were collected using a predesigned questionnaire. The questionnaire covered all the necessary items in the research. Data were collected through personal interviews with the participants and filling the questionnaires. Results: The prevalence of diabetic foot among the included diabetic patients was 52.8%. 77.8% had type II and 22.2% had type I, 83.3% had glucometer and 38.9% monitor their blood glucose level daily, 41.7% were obese, 77.8% had hypertension, 52.8% had hyperlipidemia. Only 11.1% examined the pulse and sensation the foot of the population. For diabetes control, 58.3% of them use oral tablets, 27.8% use insulin injection and 13.9% use both tablets and insulin but 52.8 of them have complication with treatment. Conclusion: The prevalence of diabetic foot among the included diabetic patients was high (52.8%). This emphasizes the importance of the more health education and better management of the diabetic patients in order to reduce the burden of health care costs of diabetic foot.

Prevalence and Risk Factors of Diabetic Septic Foot among Attendees of Diabetes Center of Arar City, Northern Saudi Arabia

Background: Diabetic septic foot contributes significantly to morbidity and mortality of patients with diabetes leading to substantial physical, physiological and financial burden for the patients and community at large. Objective: to determine the prevalence, patterns and risk factors of diabetic foot ulcers amongst patients with diabetes mellitus who were attending the diabetes center of Arar city in the period of the study. Methods: This was a retrospective study in the patients of the diabetes center of Arar city, Northern Saudi Arabia. The study was carried out during the period from 1 April to 31 May, 2018. All the patients attended the diabetes center in the period of the study were included in our data. The data were collected using a predesigned questionnaire. The questionnaire covered all the necessary items in the research. Data were collected through personal interviews with the participants and filling the questionnaires. Results: The prevalence of diabetic foot among the included diabetic patients was 52.8%. 77.8% had type II and 22.2% had type I, 83.3% had glucometer and 38.9% monitor their blood glucose level daily, 41.7% were obese, 77.8% had hypertension, 52.8% had hyperlipidemia. Only 11.1% examined the pulse and sensation the foot of the population. For diabetes control, 58.3% of them use oral tablets, 27.8% use insulin injection and 13.9% use both tablets and insulin but 52.8 of them have complication with treatment. Conclusion: The prevalence of diabetic foot among the included diabetic patients was high (52.8%). This emphasizes the importance of the more health education and better management of the diabetic patients in order to reduce the burden of health care costs of diabetic foot.

Herbal medicine foot bath for the treatment of diabetic peripheral neuropathy: protocol for a randomized, double-blind and controlled trial

BackgroundAs a common complication of diabetes, the incidence of diabetic peripheral neuropathy (DPN) is 60–70% worldwide. DPN is a major risk factor for diabetic foot, which may lead to foot ulceration and even amputation. The treatment of DPN remains challenging. Our preliminary study demonstrated that the external application of Tangbi Waixi (TW) decoction to the lower extremities relieved clinical symptoms and improved nerve conduction velocity in DPN patients. The aim of this study was to verify the efficacy of TW among DPN patients and evaluate the herb mixture’s safety using rigorous methodological designs.Methods/designThis study is a multicenter, double-blind, randomized controlled trial. A total of 640 DPN patients will be recruited and randomized to receive a foot bath with either the TW decoction or control drug. Participants will be assessed at baseline and 12 and 24 weeks after treatment. The primary outcome was the change of the Toronto Clinical Scoring System (TCSS). Secondary outcomes were nerve conduction velocity, blood glucose, blood lipids, serum inflammatory cytokines, and the European Quality of Life Five-Dimension Scale (EQ-5D) and TCM symptom scores.DiscussionThis multicenter, prospective, randomized clinical trial will provide valuable data regarding the efficacy and safety of foot bath treatment with TW decoction. Positive results would provide a novel treatment regimen for DPN patients.Trial registrationChinese Clinical Trial Registry, ChiCTR-IOR-16009331. Registered on 8 October 2016.

Application of risk grade management based on the three-stage treatment mode in patients of diabetic foot

Objective To discuss the application value of risk grade management based on the three-stage treatment mode in the prevention of diabetic foot. Methods A total of 150 diabetic patients in Tianjin Binhai New District Community from January 2016 to January 2017 were enrolled in the study by convenient sampling method. According to the weighted integral of Gavin's diabetic foot risk factors, the subjects were divided into low, medium and high risk groups. Under the three-stage treatment mode, different levels of risk were incorporated into different management levels. Subjects were followed up for 12 months using grade management mode. The incidence of foot ulcers, risk grade of diabetic foot, lower extremity arterial blood supply, and foot self-care ability were observed. Results After the intervention, 8 patients were diagnosed with stage I diabetic foot ulcer, and the scores of risk factors of diabetic foot were lower than those before the intervention; the differences were statistically significant (P<0.05). The ankle brachial pressure indices of lower extremity artery was higher than that before the intervention, the score of diabetic foot self-care ability was (55.4±7.5) points, which was significantly higher than that before the intervention; and the differences were statistically significant (P<0.05). Conclusions The implementation of the risk grade management for diabetic foot based on three-stage treatment mode reduces the risk factors of diabetic foot, improves the peripheral vascular disease, the foot self-care ability, and the quality of life of diabetic patients. Key words: Diabetic foot; Nursing care; Risk grade management; Three-stage treatment

Knowledge and Awareness of Diabetic Foot Complications in Diabetic Patients

Background: diabetic foot problems are common throughout the world, resulting in major economic consequences for the patients, their families, and society. Foot ulcers are more likely to be of neuropathic origin, and therefore eminently preventable, in developing countries, which will experience the greatest rise in the prevalence of type 2 diabetes. Aim of the Work: to assess the level of awareness of Diabetic foot disease amongst patients with type 2 diabetes mellitus aim. To measure the knowledge of diabetic about sign and symptoms of diabetic foot. To measure the knowledge of risk factors of diabetic foot in diabetic patients. Patients and Methods: this is a questionnaire-based cross-sectional study enrolling a total of 100 randomly selected diabetic foot Saudi adults ensuring diversity in age range and educational stages. Descriptive analysis was done using Statistical Package for Social Sciences (SPSS) 23. Awareness levels for DF were calculated as absolute frequencies and were reported as overall percentages. Results: a number of 99 participants with type 2 Diabetes Mellitus participated in the study, 91% of the participants were either overweight or obese, 92% of participants had concomitant hypertension, (57.5%), dyslipidemia and (26.7%) eye problems. Also 76% of the specimen reported altered sensation in their lower limbs, and 90% reported having no previous diabetic foot disease education. Only 22.2% of participants reported having examined their feet, but only when they experienced a problem. A number of participants achieved mediocre scores for knowledge (mean 4.45, standard deviation (s.d.) 2.201, confidence interval (CI) 4.2–4.7) and practice (mean 11.09, s.d. 2.233, CI 10.8–11.5) on diabetic foot care (DFC). Those who had a higher level of education and who were less than 65 years old had a significantly better score for previous foot care education (p <0.05). Conclusion: The study demonstrated that awareness of DFD was suboptimal, based on current DFC guidelines. To minimize the burden of DFD, improved screening and prevention programs as well as patient education should be provided to T2DM patients, whilst maintaining an aggressive approach to risk factor modifications, footwear and identifying the at-risk foot.

Knowledge and Awareness of Diabetic Foot Complications in Diabetic Patients

Background: diabetic foot problems are common throughout the world, resulting in major economic consequences for the patients, their families, and society. Foot ulcers are more likely to be of neuropathic origin, and therefore eminently preventable, in developing countries, which will experience the greatest rise in the prevalence of type 2 diabetes. Aim of the Work: to assess the level of awareness of Diabetic foot disease amongst patients with type 2 diabetes mellitus aim. To measure the knowledge of diabetic about sign and symptoms of diabetic foot. To measure the knowledge of risk factors of diabetic foot in diabetic patients. Patients and Methods: this is a questionnaire-based cross-sectional study enrolling a total of 100 randomly selected diabetic foot Saudi adults ensuring diversity in age range and educational stages. Descriptive analysis was done using Statistical Package for Social Sciences (SPSS) 23. Awareness levels for DF were calculated as absolute frequencies and were reported as overall percentages. Results: a number of 99 participants with type 2 Diabetes Mellitus participated in the study, 91% of the participants were either overweight or obese, 92% of participants had concomitant hypertension, (57.5%), dyslipidemia and (26.7%) eye problems. Also 76% of the specimen reported altered sensation in their lower limbs, and 90% reported having no previous diabetic foot disease education. Only 22.2% of participants reported having examined their feet, but only when they experienced a problem. A number of participants achieved mediocre scores for knowledge (mean 4.45, standard deviation (s.d.) 2.201, confidence interval (CI) 4.2–4.7) and practice (mean 11.09, s.d. 2.233, CI 10.8–11.5) on diabetic foot care (DFC). Those who had a higher level of education and who were less than 65 years old had a significantly better score for previous foot care education (p <0.05). Conclusion: The study demonstrated that awareness of DFD was suboptimal, based on current DFC guidelines. To minimize the burden of DFD, improved screening and prevention programs as well as patient education should be provided to T2DM patients, whilst maintaining an aggressive approach to risk factor modifications, footwear and identifying the at-risk foot.

Risk Factors of Diabetic Foot in Type 2 Diabetic Patients, Menoufia University Hospital, Egypt.

Risk Factors of Diabetic Foot in Type 2 Diabetic Patients, Menoufia University Hospital, Egypt.

Effects of the whole nursing intervention on the control of the risk factors of diabetic foot

Objective To investigate the effects of the whole nursing intervention on the control of the risk factors of diabetic foot. Methods A total of 600 cases of type 2 diabetes patients with the risk factors of diabetic foot were randomly divided into observation group and control group, 300 respectively. For each group, there were three subgroups of low, medium and high risk of diabetic foot with 100 cases in each subgroup. Patients in two groups were given the whole nursing intervention and routine nursing intervention respectively. The foot skin conditions, ankle brachial index (ABI) and sensory threshold determination, weighted integral score of risk factors of diabetic foot and the incidence of diabetic foot before the intervention, 6 months post intervention, 12 months post intervention and 18 months post intervention were compared between two groups. Results Before the intervention, there were no statistically significant differences in the foot skin conditions, determination of ABI and sensory threshold, weighted integral score of risk factors of diabetic foot and the incidence of diabetic foot between two groups (P>0.05) . At 6 months post intervention, 12 months post intervention and 18 months post intervention, significant differences in the foot skin conditions were observed between two groups (P 0.05) . At 12 and 18 months post intervention, there were statistically significant differences in the ABI and sensory threshold value between two groups (P<0.05) . At 18 months post intervention, comparison of weighted integral scores of risk factors of diabetic foot between two groups showed that, in the observation group, the ratio of subgroup with low-risk increased, while the ratios of subgroups with medium and high-risk decreased; in the control group, the ratio of subgroup with low-risk decreased, while the ratios of subgroups with medium and high-risk increased. The differences were statistically significant (P<0.01) . There were 10 cases of diabetic foot in the observation group and 38 cases in the control group. The number of diabetic foots in the observation group was significantly lower than that in the control group, with a statistically significant difference (P<0.01) . Conclusions The effect of the whole nursing intervention on the control of the risk factors of diabetic foot is remarkable. Key words: Diabetic foot; Risk factor; Nursing intervention

The relationship of Interleukin-6 -174 G > C gene polymorphism in type 2 diabetic patients with and without diabetic foot ulcers in Turkish population

ObjectiveWe aims investigate Turkish type 2 diabetic patients with/without diabetic foot ulcers and healthy group and examined the contribution of Interleukin (IL)-6 -174 G>C gene polymorphism to the development of diabetic foot ulcers. Design and patientsThe Interleukin (IL)-6 -174 G>C genotypes were determined prospectively in 50 patients with diabetic foot ulcers and 35 without diabetic foot ulcers and a control group of 119 healthy individuals. Genotyping of the Interleukin (IL)-6 -174 G>C gene polymorphisms for all individuals was performed by PCR-RFLP method. ResultsThe genotype IL6 distribution did differ between the control group (CC 13.3%, GC 66.7%, GG 20%) and type 2 diabetic patients (CC 2.4%, GC 47.1%, GG 50.6%) (P<0.001). The genotype IL6 distribution did not differ between type 2 diabetic patients group (CC 0%, GC 45.7%, GG 54.3%) and diabetic foot ulcers (CC 4%, GC 48%, 48%) (P>0.05). The frequency of the polymorphic G allele in between the control group and type 2 diabetic patients was no similar for the groups (58.4% and 74.1%, respectively) (p<0.05). The frequency of the polymorphic G allele in between the type 2 diabetic patients and diabetic foot ulcers was similar for the groups (77.1% and 72%, respectively) (p>0.05). ConclusionThe gene polymorphism of Interleukin-6 -174 G>C and G allele are an risk factor for diabetes, but gene polymorphism of Interleukin-6 -174 G>C is not an independent risk factor for diabetic foot. Genetic factors in the pathogenesis of diabetic foot may also show any changes in different populations.

Differences between genders in relation to factors associated with risk of diabetic foot in elderly persons: A cross-sectional trial

AimsThis trial aims to identify differences between genders in relation to factors associated with the risk of diabetic foot in elderly persons. MethodsWe evaluated 187 older adults diagnosed with diabetes type 2. The variables investigated were sociodemographic data, clinical history of diabetes mellitus and complaints about the feet. The plantar sensitivity was evaluated on both feet, with the use of Semmes–Weinstein monofilaments. For data analysis we used chi-square test and binary logistic regression (p < 0.05; 95% CI). ResultsWe included 174 elderly people who had no history of stroke and peripheral vascular disease. Most (58.6%) were female and among them the risk factors for diabetic foot were older age (p < 0.021; OR 6.0), presence of calluses (p < 0.046; OR 2.83) and claw toes (p < 0.041; OR 3.18). And among men, the risk factors for diabetic foot were insulin use (p < 0.008; OR 5.22), presence of sensory comorbidities (p < 0.007; OR 5.0), ulcers (p < 0.001), numbness (p < 0.002; OR 6.6) and stiffness in the feet (p < 0.009; OR 5.44). ConclusionThe factors associated with the development of diabetic foot were presented differently in women and men, so a targeted and more specific preventive approach is required.

Prevalence of main risk factors of diabetic foot among diabetic patients attending specialized center for diabetes in Baghdad, Iraq 2013

Introduction: Diabetic foot is one of the most disabling complications with substantial morbidity. It remains the most common reason for hospital admission, impairs quality of life, engenders high treatment costs and is the most important risk factor for amputation. Objectives: To determine the prevalence of diabetic foot among diabetic patients and the prevalence of main related risk factors. Methods: A cross-sectional study was performed in Specialized Center for Diabetes in Baghdad - Iraq in which 410 diabetic patients age range 30–83 years were selected using convenient sample from 1st June - 31st September 2013. Data was collected by direct interview using a questionnaire, physical examination, patients' records and laboratory investigations. The data was analyzed using Minitab software version 16. Results: Among 410 diabetic patients, females (56.83%) and males (43.17%). The prevalence of diabetic foot among diabetic patients was 19.27%. The following risk factors showed a statistically significant association with diabetic foot development: male gender (P = 0.047), duration of diabetes mellitus (P = 0.001), history of bare foot (P = 0.001), non-self-cleaning of foot (P = 0.001), hypertension (P = 0.006), irregular visits to diabetes center (P = 0.016) and uncontrolled level of HbA1c (P = 0.001). Applying binary logistic regression analysis revealed an independent significant association with diabetic foot development with: history of barefoot (AOR = 2.95), non-self-cleaning of foot (AOR = 2.24), male gender (AOR = 2.17), duration of diabetes mellitus (AOR = 1.37) and uncontrolled level of HbA1c level (AOR = 5). Conclusions and recommendations: There is a high prevalence of diabetic foot among diabetic patients. The study recommends implementing the knowledge of main risk factors into preventive policies and investing more financial support on training programs in primary health care and specialized centers, patient education and DF problem awareness programs.

Fatores de risco para ulceração e amputação de extremidades inferiores em portadores de diabetes mellitus

Objective: To analyze the risk factors for lower-extremity ulceration and amputation in patients with diabetes mellitus. Method: Quantitative cross-sectional study conducted in 2013 with 92 individuals with diabetes attending a Family Health Care Center in Maceio, Alagoas, Brazil, through interviews and clinical examination of the feet. The following variables were assessed: sociodemographic characteristics (gender, age group, skin color, marital status, education and income) and additional risk factors for diabetic foot (clinical data, lifestyle and foot self-care practices). Chi-squared test with Yates’ correction, G Test and Fisher’s Exact test were used to check for association between variables considering a significance level of 5% (p<0.05). Results: The sample included 92 patients with diabetes mellitus: 71.7% (66) were women and the predominant age group was 60-79 years – 48.0% (44). There was a prevalence of 95.6% (88) of individuals at risk for ulceration and 4.4% (4) were at risk for amputation. Regarding the risk of ulceration, 64.1% (59) were classified as risk 0 (lowest risk). Conclusion: There was a higher prevalence of patients at lower risk for ulceration and amputation. The inappropriate use of shoes stands out as the most common risk factor and tobacco use appears as a risk factor with significant statistical association.

Foot care practices of diabetic patients in Saudi Arabia.

Diabetic foot is a serious complication that causes lower extremity amputations. The aim of this study was to identify the patient’s awareness about risk factors for diabetic foot disease and to explore the knowledge and foot care practices among diabetic patients in a Saudi population. This cross-sectional study was conducted in King Khalid University Hospital (KKUH), King Abdulaziz University Hospital (KAUH), King Fahad Medical City, National Guard Hospital, Military Hospital, and Prince Salman Hospital capital city of Saudi Arabia. Patients were eligible if they had diabetes foot disease, signed the consent form, and completed the questionnaire. We selected 350 patients from different hospitals between November-2011 and April-2012. The majority of patients (68%) were selected from King Saud University hospitals. The mean age of patients was 50.87 ± 15.9 years with a range of 20–90 years. The majority of patients were male (64.3%) and had a family history of hypertension (55.4%), high total cholesterol (58.6%), and other diabetes (58.9%). A family history of smoking, a major risk factor for diabetic foot, was found in 20.3% of cases. Sixty percent of the patients were using oral medications, 27.1% were using insulin therapy, 10% were using both oral and insulin therapies, and 10% were on diet. In our study, 19.4% of participants were illiterate while 80.6% had a high school or university level education. Our findings also revealed that some patients had a lack of knowledge concerning diabetic foot disease and future complications. Patients are unaware of the risk factors for diabetes foot and practice poor foot care. Awareness programs should be mandatory in all hospitals and diabetes clinics to help compensate for the lack of awareness and lack of podiatric educational services. Such programs may decrease the risk of diabetes foot disease.

Main risk factors for diabetic foot

Materials and methods Descriptive, cross-sectional study evaluated 130 diabetics type 1 and 2, over 18 yrs. old. The survey instrument adapted from “Rastreamento e avaliacao precoce dos fatores de risco e prevencao do pe diabetico”, developed by SBD/DF and Grupo de Pe Diabetico do Brasil, was applied to analyze neuropathic symptoms, feet clinical inspection, loss of protective sensation (LPS), peripheral arterial disease (PAD), ulcers, amputation and risk classification – 0: without LPS and PAD, 1: presence of LPS ±deformities, 2: PAD±LPS, 3: previous ulcers and/or amputation.

The relationship of the apolipoprotein E gene polymorphism in Turkish Type 2 Diabetic Patients with and without diabetic foot ulcers

AimsThe aim of this study was to investigate the association between Apolipoprotein E (ApoE) gene polymorphism in the development of diabetic foot ulcers in Type 2 diabetes Turkish patients. Materials and methodsThe ApoE genotypes were determined retrospectively in 50 patients with diabetic foot and 50 without diabetic foot and a control group of 50 healthy individuals. ResultsThe genotype ApoE distribution did differ between the control group (E2E3 44%, E3E3 38%, E3E4 18%) and Type 2 Diabetic Patients (E2E3 6%, E3E3 81%, E3E4 16%) (p<0.001). The genotype ApoE distribution did not differ between Type 2 Diabetic Patients group (E2E3 4%, E3E3 86%, E3E4 4%) and diabetic foot ulcers (E2E3 8%, E3E3 76%, E3E4 16%) (p>0.05). The frequency of the E2,E3,E4 allele in between the control group and Type 2 Diabetic Patients were no similar for the groups (E2 22%, E3 69%, E4 9% and E2 3%, E3 90.5%, E4 6.5%, respectively) (p<0.001). The frequency of the E2–E4 allele in between the Type 2 Diabetic Patients and diabetic foot ulcers were similar for the groups (E2 2%, E3 93%, E4 5% and E2 4%, E3 88%, E4 8%, respectively) (p>0.05). ConclusionsThe gene polymorphism of ApoE and E3 allele are a risk factor for diabetes, but gene polymorphism of ApoE is not an independent risk factor for diabetic foot. Lack of association between ApoE gene polymorphism and Type 2 diabetic foot ulcers might be due to ethnic differences.

Risk factors of diabetic foot of neuropathic origin in patients with type 2 diabetes.

Diabetic foot is a diabetes mellitus complication leading to recurrent ulcerations, risk of osteomyelitis and tissue necrosis which may finally result in amputation. Diabetic foot of neuropathic origin manifesting as autonomic and sensory motor neuropathy is the most common type of this complication. The aim of this study was to identify risk factors of diabetic foot of neuropathic origin occurrence in patients with type 2 diabetes. The study included 240 patients, 74 with diabetic foot of neuropathic origin and 166 with diabetes. Cases and controls were matched in terms of age structure. Patients with peripheral arterial disease were excluded from the study. The study was conducted in the Gastroenterology and Metabolic Diseases Department, Medical University of Warsaw, Poland. We used logistic regression models, χ2, U Mann-Whitney's and t-Student tests. Logistic regression analysis showed that diabetic foot of neuropathic origin risk factors were: male gender (OR = 6.63; 95% CI: 3.31-13.27; p = 0.00001), duration of diabetes (OR = 1.10; 95% CI: 1.06-1.14; p = 0.00001), height (OR = 1.09; 95% CI: 1.06-1.13; p = 0.00001), weight (OR = 1.04; 95% CI: 1.04-1.06; p = 0.00001) and waist circumference (OR = 1.05; 95% CI: 1.02-1.08; p = 0.001). Although there was a correlation between diabetic foot of neuropathic origin and BMI value, it had no impact on DF occurrence risk. It is possible to identify patients at risk of diabetic foot development by evaluating anthropometric features. The existence of specific factors increasing the odds of diabetic foot of neuropathic origin occurring may lead to the identification of patients at risk of its development.

Development and assessment of a simple scoring system for the risk of developing diabetic foot

Identification of risk factors for diabetic foot and creation of risk classifications based on these factors are important for prevention of diabetic foot. We have created a simple screening score system based on information obtained during routine medical checkups to identify patients at high risk of developing diabetic foot and examined the efficacy of this system. We compared 108 patients in the diabetic foot ulcer group with 108 age and sex-matched controls who were hospitalized at Saiseikai Central Hospital in Tokyo. The risk scores of 316 diabetic outpatients whose feet were examined from April 2011 to September 2012 were calculated. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the ability of the risk score to diagnose high-risk patients in categories ≥1 of the risk classification of the International Working Group on the Diabetic Foot (IWGDF). Differences between the ulcer and control groups were observed for 5 items: (1) diabetes duration, (2) average corrected bilateral visual acuity, (3) estimated glomerular filtration rate, (4) marital status, and (5) occupation. Multiple logistic analysis was performed using these items as independent variables, and the scoring system was created from the odds ratios. The scoring system cutoff value (≥7) was 56.9 % sensitive and 95.2 % specific for patients in IWGDF category ≥1 when applied in 316 outpatient foot examinations, and its ROC area under the curve was 0.865 (95 % CI, 0.83–0.91). High-risk diabetes patients were effectively identified by evaluating risk factors that included social characteristics and clinical examination findings.

Analysis of risk factors of diabetic foot in elderly diabetic patients

Objective To discuss the risk factors of diabetic foot in elderly diabetic patients , in order to provide references for effective nursing methods and clinical treatment .Methods 83 cases of elderly diabetic patients with diabetic foot were chosen as the observation group , and 71 cases of elderly diabetic patients without diabetic foot were chosen as the control group .Clinical features and laboratory test results were compared and analyzed to discuss the risk factors of diabetic foot .Results The age, history of diabetic mellitus, HbAlc, FIB, MA, ALB of patients in the observation group was respectively （63.34 ±177;5.12） years old,（95.4 ±177; 52.7）months,（11.38 ±177;2.14）%,（6.12 ±177;1.33） g/L,（175.32 ±177;46.17） mg/d,（25.19 ±177;6.13） g/L in the observation group and there were 41 patients with smoking history , significantly different from that in the control group （t =0.73,0.81,4.72,5.72,4.92,3.24,χ2 =8.25, respectively; P <0.05）.Logistic regression analysis showed that age （OR=1 173, P=01017）, FIB（OR=1.936, P=0.018） and HbA1c（OR=2.759, P=0.024） were the independent risk factors of diabetic foot , while ALB（OR=1.034, P=0.016） was an independent protective factor .Conclusions Age, FIB and HbA1 c were the independent risk factors of diabetic foot, while ALB was an independent protective factor .Nursing intervention strategies , active control of blood glucose, improvement of nutritional status , early health education , enhancement of disease knowledge and essential foot nursing are important to prevent diabetic foot . Key words: Elderly; Diabetic foot; Risk factor; Nursing intervention