Prevalence of factors predisposing to foot complication and their relation to other risks

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.

To evaluate the prevalence of diabetic neuropathy and PVD in Thai patients with T2DM and to determine other factors that related with them.

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.

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 > or = 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).

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.