Prevalence and predictors of diabetic foot syndrome in type 2 diabetes mellitus in Jordan

Saudi Med J. 2003 Jul;24(7):761-4.

Abstract

Objective: To detect feet changes and to identify risk factors leading to amputation among type 2 diabetics.

Methods: A total of 1142 patients with type 2 diabetes mellitus; 595 males (52%), and 547 females (48%) were seen between January and December 2001 at the National Center for Diabetes, Endocrinology, and Genetics (NCDG) Amman, Jordan. The mean age was 56.1 years (SD=10.2) and the mean duration of diabetes was 9 years (SD=7.1). All patients had a complete medical assessment including history, physical examination, glycosylated hemoglobin (HbA1c) (the mean of the last 4 readings) and microalbuminuria. Statistical analysis were performed to identify significant risk factors leading to amputation using Epi info, version 6 software.

Results: Mean HbA1c was 7.4% (SD=1.4). The prevalence of hypertension was 52%, retinopathy 45% and microalbuminuria 33%. Impaired vibration, position and protective sense were found in 19%, 13%, and 18%. The prevalence of all amputations was 5%. The following were strong predictors of amputation; duration of diabetes (P= 0.04), smoking (P=0.01), microalbuminuria (P=0.02), retinopathy (P=0.008), legs hair loss (P=0.003), neurological deficit (P=0.0001), ulceration (P=0.00001) absent dorsalis pedis (P=0.0006) and insulin therapy (P=0.0001). The rate of amputation was directly proportional to high HbA1c >= 8% (P=0.01). Age and gender were not found to have an impact on prevalence of amputation.

Conclusion: Prevalence of amputation correlates with duration of diabetes, poor glycemic control, smoking, neurological impairment, peripheral vascular disease and microalbuminuria.

MeSH terms

  • Amputation, Surgical
  • Diabetic Foot / epidemiology*
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Jordan / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors

Substances

  • Glycated Hemoglobin A