Health-related quality of life among patients with diabetes and foot ulcers: association with demographic and clinical characteristics

Objective: The purpose of the study was to describe the sociodemographic variables, clinical characteristics, and treatment factors in patients with diabetic foot ulcers (DFU) and to explore the associations between these factors and the patients' health-related quality of life (HRQL). Materials and methods: Cross-sectional data were obtained from 127 patients consecutively recruited from six hospital outpatient clinics. The patients were over 20 years of age, had current DFU, and had been diagnosed with diabetes of either Type 1 or Type 2. Data were obtained by clinical and laboratory examination and by self-completed questionnaires (SF-36). Descriptive analyses, bivariate analyses, and hierarchical regression analyses in three blocks were performed. Results: The patients' mean age was 60 years (S.D., 13.8 years); 72% were men, and 29% had Type 1 diabetes. The most important variables explaining the variance in HRQL were the presence of biochemical signs of inflammation as measured by the detection of C-reactive protein (CRP) > 10 mg/l, an ankle-brachial index (ABI) < 0.9, an ulcer size 5 cm, nephropathy, and a body mass index < 25 kg/m. The strongest association occurred 2 between biochemical signs of inflammation CRP >10 mg/l, ABI <0.9, ulcer size > 5cm(2), and HRQL on physical functioning (adjusted r(2) =24). A major part of the variance remained unexplained and should be investigated in future studies. Conclusion: The findings may tend to identify the most vulnerable subgroups among those with DFU and may be useful in the formulation of strategies to improve function and HRQL in these patients. (C) 2007 Published by Elsevier Inc.