Predictors of Diabetic Foot and Leg Ulcers in a Developing Country with a Rapid Increase in the Prevalence of Diabetes Mellitus

被引:26
|
作者
Sriyani, Kumarasinghe A. [1 ]
Wasalathanthri, Sudharshani [2 ]
Hettiarachchi, Priyadharshika [3 ]
Prathapan, Shamini [4 ]
机构
[1] Open Univ Sri Lanka, Dept Hlth Sci, Nawala, Sri Lanka
[2] Univ Colombo, Dept Physiol, Colombo, Sri Lanka
[3] Univ Sri Jayewardenepura, Dept Physiol, Nugegoda, Sri Lanka
[4] Univ Sri Jayewardenepura, Dept Community Med, Nugegoda, Sri Lanka
来源
PLOS ONE | 2013年 / 8卷 / 11期
关键词
SEMMES-WEINSTEIN MONOFILAMENT; DIFFERENT SCREENING-TESTS; RISK-FACTORS; PERIPHERAL NEUROPATHY; CARE; ULCERATION; POLYNEUROPATHY; ASSOCIATION; COMMUNITY; PEOPLE;
D O I
10.1371/journal.pone.0080856
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Objective: To identify the socio demographic, life style and foot examination related predictors of diabetic foot and leg ulcers with a view to develop a screening tool appropriate for the use in an outpatient setting. Research design and methods: This cross sectional study included type 2 diabetes mellitus (DM) patients; 88 subjects with leg and foot ulcers and 80 non ulcer controls. Socio demographic data and life style factors were documented. Foot was examined for skin changes and structural abnormalities. Distal peripheral neuropathy was assessed by pressure sense, vibration sense and joint position sense. Multivariate analysis by logistic regression was used to determine the significant predictors in screening for foot ulcers. Results: Education of grade 6 and below (OR - 1.41, 95% CI; 1.03 - 4.68), low income (OR -23.3, 95% CI; 1.5 - 34.0), impaired vibration sense (OR - 24.79, 95% CI; 9.3 - 66.2), abnormal monofilament test on first (OR - 1.69, 95% CI; 1.36 - 16.6), third (OR - 3.4, 95% CI; 1.1 - 10.6) and fifth (OR - 1.8, 95% CI; 1.61-12.6) toes are found to be predictors of increased risk whereas incidental diagnosis of DM (OR - 0.03, 95% CI; 0.003 - 0.28), wearing covered shoes (OR - 0.003, 95% CI; 0.00 - 0.28), presence of normal skin color (OR - 0.01, 95% CI; 0.001 - 0.14) and normal monofilament test on first metatarsal head (OR - 0.10, 95% CI; 0.00 - 0.67) are protective factors for ulcers. Conclusions: Ten independent risk and protective factors identified in this study are proposed as a simple screening tool to predict the risk of developing leg and foot ulcers in patients with DM.
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页数:6
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