Risk factors associated with the development of ulcers in patients with diabetes mellitus type 2: seven years of experience
DOI:
https://doi.org/10.47196/diab.v52i1.79Keywords:
diabetic foot, ulcer, risk factorsAbstract
Introduction: lower extremity amputations related to diabetes are preceded by a foot ulcer. Risk factors include neuropathy, peripheral vascular disease, high plantar pressures, minor trauma, previous ulceration or amputation, and visual impairment.
Objectives: to determine the risk factors related to the development of standing ulcer in diabetic patients assisted in the Provincial Unit of Diabetic Foot (UPPD) in the Hospital Córdoba, Argentina.
Materials and methods: transversal and descriptive study in adults with type 2 diabetes mellitus (DM2) who consulted the UPPD (July 2008-July 2015).
Results: a total of 2.990 patients were evaluated, 58.3% male. 54.9% were treated with OADs and 30.5% with insulin, mean HbA1c 8.4%. 34.9% of the patients presented ulcer, 14.5% infection and 34.7% vascular alteration. 72.5% had some degree of neuropathy (25.8% severe, 22.1% moderate and 24.6% mild). Overall, 9.4% had suffered a previous amputation (7.4% lower and 2% higher) and 30.5% presented orthopedic alterations.
The risk of ulcer was higher in patients with vascular alteration, OR 2.63 (p<0.001), with more than 10 years of evolution of diabetes, OR 2.19 (p<0.05) and in patients with orthopedic disorders, OR 1.64 (p<0.05).
The presence of neuropathy was associated with ulcer risk, OR 2.31 (p<0.05). Patients with severe neuropathy presented an OR 5.9 (p<0.001) and those with moderate had an OR 2 (p<0.001).
Conclusions: the main risk factors associate to ulcer development are neuropathy (mainly severe neuropathy), peripheral vascular disease, evolution time of the disease, orthopedic disorders and poor metabolic control.
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