FACTORS ASSOCIATED WITH DIABETIC FOOT ULCERATION IN THAILAND - A CASE-CONTROL STUDY

A case-control study was conducted to determine factors involved in fo ot ulceration in Thai non-insulin-dependent (Type 2) diabetic patients . Fifty-five patients with foot ulcers (42 females and 13 males) and 1 10 patients without foot ulcers (83 females and 27 males) were evaluat ed for 26 factors possibly associated with foot ulceration. The result s showed that diabetic patients with foot ulcers had significantly low er diabetic knowledge and foot-care practice scores; poorer glycaemic control, renal function, and visual function, and higher prevalence of retinopathy and peripheral neuropathy than diabetic patients without foot ulcers, whereas there were no differences in peripheral vascular status between both groups, each having a low prevalence. Multiple log istic regression analyses indicated that the risk of developing foot u lcers was associated with only three factors which were peripheral ner ve status as determined by somatosensory evoked potentials (OR = 1.67; 95 % CI 0.31-8.97), visual acuity (OR = 0.223 per unit decrease in de cimal visual acuity; 95 % CI = 0.005, 0.39) and fasting plasma glucose level (OR = 1.01 mmol l(-1) increase; 95 % CI = 1.00, 1.02). We concl ude that peripheral neuropathy, visual impairment, and poor glycaemic control, but not peripheral vascular insufficiency, are the major inde pendent risk factors associated with foot ulceration in Thai diabetic patients.