S. Sriussadaporn et al., FACTORS ASSOCIATED WITH DIABETIC FOOT ULCERATION IN THAILAND - A CASE-CONTROL STUDY, Diabetic medicine, 14(1), 1997, pp. 50-56
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.