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Regional differences in risk factors and clinical presentation of diabetic foot lesions

Morbach, S., Lutale, J. K., Viswanathan, V., Möllenberg, J., Ochs, H. R., Rajashekar, S., Ramachandran, A., Abbas, Z. G.·2004·Diabetic Medicine
DOI 10.1046/j.1464-5491.2003.01069.x
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Abstract

Background Problems associated with the diabetic foot are worldwide. However, there may be regional variation among risk factors and clinical presentation. Prospective comparative data concerning this topic are rare. Aim To determine differences in underlying risk factors and clinical presentation of foot problems among people with diabetes in different regions. Patients and methods Six hundred and thirteen consecutive patients with diabetic foot lesions from three centres [Soest‐Germany (GER), Dar‐es‐Salaam, Tanzania (TAN) and Chennai, India (IND)] were included during the period June 1998 through December 1999. Diabetes‐related data, risk‐factor profiles, and lesion‐related data were collected for each patient. Due to varying proportions of recurrent lesions among the centres, only data from patients with newly presenting diabetic foot lesion were analysed. Results Of the 613 patients sampled, 368 (60%) were treated for newly presenting diabetic foot lesion. In all three centres, patients were predominately male and had Type 2 diabetes. The average diabetes duration until the onset of the initial foot lesion was 14 years in GER and 12 years in IND, but only 5 years in TAN. The corresponding patient ages were 71, 56 and 51 years. Neuropathy was common to patients in all three centres. Peripheral vascular disease (PVD) was a frequent risk factor in GER (48%). In TAN and IND it was far less common (12 and 13%), probably due to younger patient populations, shorter diabetes duration and lower proportions of smokers. Inadequate footwear was the most common cause of foot lesions in GER (19%), while lack of footwear, irregular foot care and burns were the primary precipitating factors among patients in TAN and IND. Conclusion Similarities in different regions of the world among people with diabetes suffering newly presenting foot lesions include a predominance of males and patients with Type 2 diabetes, as well as a high frequency of diabetic neuropathy. However, differences concerning age, diabetes duration, peripheral vascular disease, and precipitating factors contributing to injury are also observed.

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Metadata

Authors
Morbach, S., Lutale, J. K., Viswanathan, V., Möllenberg, J., Ochs, H. R., Rajashekar, S., Ramachandran, A., & Abbas, Z. G.
Venue
Diabetic Medicine
Publisher
Wiley
Published
2003-11-28
Volume
21
Issue
1
Pages
91-95
ISSN
  • 0742-3071
  • 1464-5491
DOI
10.1046/j.1464-5491.2003.01069.x
Cited by
73
References
0
Language
en
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)

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Morbach, S., Lutale, J. K., Viswanathan, V., Möllenberg, J., Ochs, H. R., Rajashekar, S., Ramachandran, A., & Abbas, Z. G. (2004). Regional differences in risk factors and clinical presentation of diabetic foot lesions. Diabetic Medicine. https://doi.org/10.1046/j.1464-5491.2003.01069.x