The North‐West Diabetes Foot Care Study: incidence of, and risk factors for, new diabetic foot ulceration in a community‐based patient cohort

Abbott, Caroline A.; Carrington, Anne L.; Ashe, H.; Bath, Sarah C.; Every, L. C.; Griffiths, Joan; Hann, Alison Wynn; Hussein, Ahmed; Jackson, Nicky; Johnson, Kristen E.; Ryder, Courtney; Torkington, R.; Ross, E. R. E. Van; Whalley, A; Widdows, P.; Williamson, Sheila; Boulton, Andrew J.M.

doi:10.1046/j.1464-5491.2002.00698.x

Cited by 920 publications

(853 citation statements)

References 22 publications

(38 reference statements)

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“…Perspectives need to be exercised, however, as most of the reported studies on the subject in SSA are old and cross-sectional in design. However, our annual incidence is higher than that observed in developed countries, where a dramatic reduction in the rate of diabetic foot has been recorded over the past two decades [8,25,26]. The North-West and West of Ireland diabetic foot studies conducted in the United Kingdom and the Republic of Ireland reported diabetic foot incidence of 2.2% and 2.6%, respectively [8,27].…”

Section: Discussionmentioning

confidence: 80%

“…However, our annual incidence is higher than that observed in developed countries, where a dramatic reduction in the rate of diabetic foot has been recorded over the past two decades [8,25,26]. The North-West and West of Ireland diabetic foot studies conducted in the United Kingdom and the Republic of Ireland reported diabetic foot incidence of 2.2% and 2.6%, respectively [8,27]. Similarly, Muller et al and de Sonnaville et al both from the Netherlands indicated an incidence of 2.1% and 1.8%, respectively [28,29].…”

Section: Discussionmentioning

confidence: 91%

“…Besides, management involves significant cost inputs regarding investigations and therapy [4]. Among high-income countries, an evident reduction in the incidence of the diabetic foot has been recorded over the past three decades [5–8]. These achievements were mostly through a campaign of increased screening, widespread adoption of multidisciplinary foot clinics and stringent vascular risk factor management [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Diabetes-related foot disorders among adult Ghanaians

Sarfo‐Kantanka

Kyei

Mbanya

et al. 2018

Diabetic Foot & Ankle

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Background: Diabetic foot remains a challenge in most low-middle-income countries (LMICs). A severe deficit in data exists on them in sub-Saharan Africa (SSA). Up-to-date data on the longitudinal trajectories and determinants can provide a benchmark for reducing diabetic foot complications in SSA. Objective: The primary objective of this study was to estimate trends in the incidence of diabetic foot and determine predictors in an adult Ghanaian diabetes cohort. Design: The study is a retrospective longitudinal study over a 12 year period. Methods: We applied Poisson regression analysis and Cox proportional hazard models to demographic and clinical information obtained from patients who enrolled in a diabetes specialist clinic in Ghana from 2005 to 2016 to identify longitudinal trends in incidence and predictors of diabetic foot. Results: The study comprised 7383 patients (63.8% female, mean follow-up duration: 8.6 years). The mean incidence of foot disorders was 8.39% (5.27% males and 3.12% females). An increase in the incidence of diabetic foot ranging from 3.25% in 2005 to 12.57% in 2016, p < 0.001, was determined. Diabetic foot, with adjusted hazard ratio (HR; 95% confidence interval (CI)), was predicted by disease duration, that is, for every 5-year increase in diabetes duration: 2.56 (1.41–3.06); male gender: 3.51 (1.41–3.06); increased body mass index (BMI), that is, for every 5 kg/m2: 3.20 (2.51–7.52); poor glycaemic control, that is, for every percentage increase in HbA1c: 1.11 (1.05–2.25), hypertension: 1.14 (1.12–3.21); nephropathy: 1.15 (1.12–3.21); and previous foot disorders: 3.24 (2.12–7.21). Conclusions: We have found a trend towards an increased incidence of diabetic foot in an outpatient tertiary diabetes setting in Ghana. Systemic and individual-level factors aimed at preventive foot screening as well as vascular risk factor control should be intensified in diabetic patients in Ghana and other LMICs. Abbreviations: BMI: Body Mass Index, BP: Blood Pressure, CI: Confidence Interval, HR: Hazard Ratio, HbA1c: Glycated Hemoglobin, PAD: Peripheral Arterial Disease, NCDs: Non Communicable Disease, SSA: Sub Saharan Africa.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Diabetes-related foot disorders among adult Ghanaians

Sarfo‐Kantanka

Kyei

Mbanya

et al. 2018

Diabetic Foot & Ankle

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“…These latter patients might therefore have had more severe disease, although in terms of ulcer stages, no differences were observed between patients who were referred by other specialists and those who were not. In addition, studies with long-term follow-up indicate that diabetic foot ulceration is a recurrent disease [34,35]. Since we excluded patients with a previous ulcer within the 12 months prior to presentation, our cohort does not properly reflect the total population attending the participating clinics.…”

Section: Discussionmentioning

confidence: 99%

High prevalence of ischaemia, infection and serious comorbidity in patients with diabetic foot disease in Europe. Baseline results from the Eurodiale study

et al. 2006

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Aims/hypothesis Large clinical studies describing the typical clinical presentation of diabetic foot ulcers are limited and most studies were performed in single centres with the possibility of selection of specific subgroups. The aim of this study was to investigate the characteristics of diabetic patients with a foot ulcer in 14 European hospitals in ten countries.Methods The study population included 1,229 consecutive patients presenting with a new foot ulcer between 1

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“…In addition, the 10 g monofilament has been found to have a similar diagnostic rate when compared to the 128 Hz tuning fork (32.6 vs 31.4%, respectively). Furthermore, the efficacy of the 10 g monofilament has been established in multiple studies [3,6]. PAD was defined as monophasic Doppler ultrasound readings, an ankle brachial pressure index (ABPI) of <0.9 or the existence of symptomatic vascular disease [4,24].…”

Section: Introductionmentioning

confidence: 99%

Diabetic foot ulcer outcomes from a podiatry led tertiary service in Kuwait

Messenger

Masoetsa

Hussain

et al. 2018

Diabetic Foot & Ankle

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Objective: This single-centred study aims to evaluate the incidence, risk factors and treatment outcomes of a podiatry led, evidence-based diabetic foot ulcer (DFU) clinic. Research design and methods: Data from the DFU database and patient electronic health records were retrospectively collected from patients with new DFUs who were referred for treatment to the Department of Podiatry, Dasman Diabetes Institute, Kuwait, from 1 October 2014, to 31 December 2016. Patients were followed-up until healing occurred or until 6 months after the study end date, whichever came first. Results: All data were analysed using IBM SPSS version 24 software. Data were collected from 230 patients with 335 DFUs. Most DFUs (67%) were present for <3 months from the time of the first podiatry appointment. A total of 56% of DFUs were classified as neuropathic. Most (72%) DFUs healed, with a median healing time of 52.0 days. Chronic kidney disease (p = 0.001), retinopathy (p = 0.03), smoking (p = 0.02), ulcer location (p = 0.03), peripheral arterial disease (PAD) (p = 0.004) and osteomyelitis (p = 0.05) were found to have a meaningful association with DFU outcome. The number of days to heal was associated with ulcer classification (p = 0.005), bacterial infection (p = 0.002), osteomyelitis (p = < 0.001) and PAD (p = < 0.001). Conclusions: The incidence of new DFUs in our tertiary clinic is 3.4%. The incidence of diabetic foot ulceration, days to heal, healing rate and the risk factors influencing healing are in accordance with other multidisciplinary facilities with podiatry input.

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The North‐West Diabetes Foot Care Study: incidence of, and risk factors for, new diabetic foot ulceration in a community‐based patient cohort

Abstract: More than 2% of community-based diabetic patients develop new foot ulcers each year. The neuropathy disability score, 10 g monofilament and palpation of foot pulses are recommended as screening tools in general practice.

Cited by 920 publications

References 22 publications

Diabetes-related foot disorders among adult Ghanaians

Diabetes-related foot disorders among adult Ghanaians

High prevalence of ischaemia, infection and serious comorbidity in patients with diabetic foot disease in Europe. Baseline results from the Eurodiale study

Diabetic foot ulcer outcomes from a podiatry led tertiary service in Kuwait

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