COMPARISON OF RISK-FACTORS FOR FOOT PROBLEMS IN DIABETIC-PATIENTS ATTENDING TEACHING HOSPITAL OUTPATIENT CLINICS IN 4 DIFFERENT EUROPEAN STATES

Although the St Vincent declaration calls for common European action i n order to reduce major amputations, the differences in the incidence of foot problems and the prevalence of risk factors has not been fully investigated. We have examined the risk factors for foot ulceration a nd amputation in 278 consecutive patients (mean age 50.4 years, range 18-79 years) attending outpatient clinics of four teaching hospitals: Athens, Manchester, Rome, and Antwerp. There were no differences in ag e, weight or sex among the four groups but the percentage of patients with Type 1 diabetes was higher in Rome and Antwerp. Patients in Rome and Antwerp also had a longer duration of diabetes compared to Athens and Manchester. Mean vibration perception threshold was similar in all groups. No differences were found in the number of patients with mode rate or severe clinical neuropathy (neuropathy disability score > 5), severe sensory loss (VPT > 25 V), and limited joint mobility. Symptoma tic peripheral vascular disease was more frequent in Antwerp (p < 0.05 ) compared to the other three centres and foot ulceration in Rome comp ared to Manchester (p < 0.05). The number of smokers or ex-smokers and the average alcohol consumption were similar in all centres. We concl ude that, despite a few differences mainly in Type 1 diabetic patients , there are no major differences in the risk factors for foot ulcerati on and that, therefore, similar strategies for the prevention of foot problems may be equally successful in different European countries.