HIGH PREVALENCE OF DIABETES IN CHRONIC LEG ULCER PATIENTS - A CROSS-SECTIONAL POPULATION STUDY

In a cross-sectional survey, designed to detect all patients with curr ent chronic leg ulcers, 27 % of the patients had diabetes mellitus. Th e outcome for the 104 examined diabetic patients has been evaluated an d compared with the 278 nondiabetic patients. The purpose was to estab lish the prevalence of leg ulcers among diabetic patients and to asses s potential causes. The point prevalence was calculated by extrapolati ng the leg ulcer frequency to the total diabetic population in the stu died area. The point prevalence for active leg ulcers (including foot ulcers) in diabetic patients was 3.5 % (95 % Cl 2.8-4.2). Ulcers above the malleoli were almost as common as foot ulcers. Peripheral vascula r disease was present in 67 % of all ulcerated legs in patients with d iabetes compared to 42 % in nondiabetic patients (p < 0.001). In 72 % of foot ulcers in diabetic patients arterial impairment was judged to be a contributing aetiological factor and in nondiabetic patients 45 % (p < 0.001). Ulcers solely attributed to possible neuropathy were les s common (15 %). Ulcers with multifactorial causes were common above t he malleoli. This survey has given the size of the problem and indicat es macroangiopathy to be the dominating factor responsible for slow or nonhealing ulcers in diabetic patients. Objective assessment of arter ial circulation is mandatory and signs of arterial impairment require consultation with a vascular surgeon.