Risk factors of diabetic foot in central Saudi Arabia.

OBJECTIVES: To identify the risk factors of diabetic foot (DF) in diabetic patients.

METHODS: In a case-control study, medical records of 50 patients with DF, and 50 diabetic controls without DF were selected randomly from the patients seen at King Abdulaziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia. Selected vascular, neuropathic, metabolic, health care, and lifestyle risk factors were investigated. Multiple logistic regression was used to relate these potential risk factors to the odds of DF.

RESULTS: Diabetic foot was significantly associated with: gender, age, education, type of diabetes, duration of disease, level of erythrocyte sedimentation rate (ESR), presence of peripheral neuropathy, peripheral vascular disease, chronic renal diseases, ischemic heart diseases, hypertension, and previous history of diabetic foot. After adjusting for the potentially confounding effects of age and gender by using the logistic regression analysis, independent predictors of DF were: the duration of diabetes, presence of neuropathy, and ESR level. In the prediction of DF, receiver operating characteristic curves (ROC) were applied to identify the most valid cut-off points of the duration of diabetes (11 years), and ESR level (54 mm/hr).

CONCLUSIONS: These findings could help diabetologists recognize early, and manage DF, and thus reduce the risk of limb amputation, and the cost that accompanies limb loss in this prevalent condition.