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Why do foot ulcers recur in diabetic patients?
I Mantey1, A V Foster, S Spencer
1King's Diabetes Centre, King's College Hospital, London, UK.
Summary
Diabetic patients with recurrent foot ulcers delay reporting symptoms and show poorer glycemic control, increased neuropathy, and higher alcohol intake compared to those without recurrence. These factors are crucial for preventing repeat ulcerations.
Area of Science:
- Diabetology
- Podiatry
- Neurology
Background:
- Recurrent foot ulceration is a significant complication for patients with diabetes mellitus.
- Identifying predisposing factors is crucial for effective prevention strategies.
Purpose of the Study:
- To investigate factors that predispose patients with diabetes mellitus to recurrent foot ulceration.
Main Methods:
- Comparison of two groups: relapsers (≥2 ulcer recurrences) and non-relapsers (no recurrence for ≥2 years).
- Assessment of symptom reporting time, vibration and cold perception thresholds, HbA1c, and alcohol intake.
Main Results:
- Relapsers significantly delayed reporting symptoms (≥24h) compared to non-relapsers.
- Relapsers exhibited significantly higher vibration perception thresholds, cold perception thresholds, HbA1c levels, and alcohol intake.
- No significant differences were found in smoking, housing, visual acuity, warm perception, or Doppler pressure index.
Conclusions:
- Delayed symptom reporting is a key factor in recurrent diabetic foot ulceration.
- Poorer glycemic control, increased peripheral neuropathy, and higher alcohol consumption are associated with ulcer recurrence in diabetic patients.