Background
Methods
Statistical analysis
Results and discussion
Patient characteristics
Variable | Mean (SD)/% |
---|---|
Age | 57.7 (14.2) |
Sex (female/male) | 58.6/41.4 |
BMI (kg/m2) | 29.3 (6.2) |
Ethnicity | |
White | 53.8 |
Black | 18.4 |
Mixed | 20.8 |
Asian | 7.0 |
Type of diabetes (1/2) | 9.3/90.7 |
Diabetes duration (years) | 14.2 (9.8) |
HbA1c (%) | 8.56 (2.03) |
Smoking | 24.2 |
Hypertension | 81.5 |
Cardiopathy | 28.5 |
Dyslipidemia | 72.9 |
Nephropathy | |
Stage 1 | 52.1 |
Stage 2 | 25.4 |
Stage 3 | 15.8 |
Stage 4 | 1.9 |
Stage 5 | 4 |
Retinopathy | 46.2 |
Visual impairment | 50.3 |
Previous ulcer | 25.3 |
Active ulcer | 18.6 |
Amputation | 13.7 |
Minor | 82.7 |
Major | 17.3 |
Foot at risk classification | |
Foot without risk | 37.8 |
Neuropathic | 33.7 |
Ischemic | 8.5 |
Neuroischemic | 20 |
Vibratory sensation | |
Normal | 55.7 |
Diminished | 29.9 |
Absent | 14.5 |
Score of symptoms | |
Normal | 20.4 |
Mild | 29.6 |
Moderate | 28.1 |
Severe | 22 |
Treatment of neuropathy (yes) | 14.1 |
Region | |
South | 18.9 |
Southeast | 38.9 |
Midwest | 3.4 |
Northeast | 38.8 |
Differences between patients with and without amputation, ulcer and mild versus moderate/severe neuropathy
Ulcer
Variable | Previous ulceration | p | |
---|---|---|---|
Yes | No | ||
Age (years) | 58.4 | 57.5 | 0.26 |
Sex (female/male) | 41.7/58.3 | 64.4/35.6 | <0.001 |
BMI (kg/m2) | 29.4 | 29.3 | 0.88 |
Ethnicity | 0.008 | ||
White | 61.2 | 51.2 | |
Black | 14.4 | 20.1 | |
Mixed | 20 | 20.9 | |
Asian | 4.4 | 7.8 | |
Type of diabetes (1/2) | 9.9/90.1 | 9.4/90.6 | 0.77 |
Diabetes duration (years) | 17.2 | 13.2 | <0.001 |
HbA1c (%) | 9.23 | 8.35 | <0.001 |
Smoking (yes) | 25.8 | 22.7 | 0.25 |
Hypertension (yes) | 80.3 | 82 | 0.49 |
Cardiopathy (yes) | 39.5 | 24.4 | <0.001 |
Dyslipidemia (yes) | 71.2 | 73.5 | 0.45 |
Nephropathy (ClCr < 60 ml/min) | 29.6 | 18.8 | <0.001 |
Retinopathy (yes) | 69.8 | 38 | <0.001 |
Visual impairment (yes) | 63.3 | 46.1 | <0.001 |
Foot at risk classification | <0.001 | ||
Foot without risk | 7.9 | 48.6 | |
Neuropathic | 52.3 | 27.2 | |
Ischemic | 4.8 | 9.9 | |
Neuroischemic | 35 | 14.3 | |
Score of symptoms | 0.44 | ||
Normal/mild | 47.3 | 49.9 | |
Moderate/severe | 52.7 | 50.1 | |
Disability score | <0.001 | ||
Normal/mild | 53.1 | 80.5 | |
Moderate/severe | 46.9 | 19.5 | |
Treatment of neuropathy (yes) | 17.3 | 11.9 | 0.015 |
Region | 0.001 | ||
South/Southeast | 65.1 | 54.6 | |
Northeast/Midwest | 34.9 | 45.4 |
Amputation
Variable | Previous amputation | p | |
---|---|---|---|
Yes | No | ||
Age (years) | 60.5 | 57.3 | 0.001 |
Sex (female/male) | 29.1/70.9 | 63.3/36.7 | <0.001 |
BMI (kg/m2) | 28.7 | 29.4 | 0.18 |
Ethnicity | 0.043 | ||
White | 63.3 | 51.7 | |
Black | 14.8 | 19.6 | |
Mixed | 18.1 | 21.1 | |
Asian | 3.8 | 7.7 | |
Type of diabetes (1/2) | 4.2/95.8 | 9.5/90.5 | 0.017 |
Diabetes duration (years) | 17.3 | 13.6 | <0.001 |
HbA1c (%) | 8.76 | 8.54 | 0.4 |
Smoking (yes) | 26.1 | 23.9 | 0.52 |
Hypertension (yes) | 72.2 | 83 | 0.001 |
Cardiopathy (yes) | 36.4 | 26.8 | 0.023 |
Dyslipidemia (yes) | 65 | 74.3 | 0.022 |
Nephropathy (ClCr < 60 ml/min) | 33.3 | 19.7 | 0.001 |
Retinopathy (yes) | 69.8 | 42.1 | <0.001 |
Visual impairment (yes) | 65 | 47.7 | <0.001 |
Foot at risk classification | <0.001 | ||
Foot without risk | 3.3 | 43.9 | |
Neuropathic | 49.5 | 30.6 | |
Ischemic | 6 | 9.1 | |
Neuroischemic | 41.2 | 16.4 | |
Score of symptoms | 0.7 | ||
Normal/mild | 47.9 | 49.5 | |
Moderate/severe | 52.1 | 50.5 | |
Disability score | <0.001 | ||
Normal/mild | 39.1 | 79.2 | |
Moderate/severe | 60.9 | 20.8 | |
Treatment of neuropathy (yes) | 19.3 | 11.5 | 0.005 |
Region | 0.069 | ||
South/Southeast | 62.4 | 55.4 | |
Northeast/Midwest | 37.6 | 44.6 |
Moderate/severe neuropathic symptoms
Variable | Score of symptoms | p | |
---|---|---|---|
Normal/mild | Moderate/severe | ||
Age (years) | 56.4 | 58.5 | 0.009 |
Sex (female/male) | 56/63 | 44/37 | 0.01 |
BMI (kg/m2) | 28.9 | 29.9 | 0.004 |
Ethnicity | 0.024 | ||
White | 58 | 49.8 | |
Black | 16.9 | 19.2 | |
Mixed | 18.4 | 22.4 | |
Asian | 6.7 | 8.5 | |
Type of diabetes (1/2) | 10.3/89.7 | 7.9/92.1 | 0.12 |
Diabetes duration (years) | 13.9 | 14.4 | 0.3 |
HbA1c (%) | 8.66 | 8.46 | 0.26 |
Smoking (yes) | 25.2 | 25.4 | 0.94 |
Hypertension (yes) | 80.1 | 84.1 | 0.063 |
Cardiopathy (yes) | 26.4 | 30.9 | |
Dyslipidemia (yes) | 71.1 | 75 | 0.15 |
Nephropathy (ClCr < 60 ml/min) | 22.4 | 21.5 | 0.48 |
Retinopathy (yes) | 42.3 | 49.1 | 0.024 |
Visual impairment (yes) | 46.1 | 54.1 | 0.006 |
Foot at risk classification | <0.001 | ||
Foot without risk | 53.8 | 27.1 | |
Neuropathic | 19.4 | 41.4 | |
Ischemic | 11.2 | 5.8 | |
Neuroischemic | 15.5 | 25.7 | |
Previous ulceration (yes) | 22.3 | 24.2 | 0.44 |
Previous amputation (yes) | 12.6 | 13.3 | 0.7 |
Treatment of neuropathy (yes) | 11.4 | 17.9 | 0.003 |
Region | <0.001 | ||
South/Southeast | 64.2 | 52.1 | |
Northeast/Midwest | 35.8 | 47.9 |
Independent risk factors for ulcer and amputation
Factor | OR | 95 % CI | p |
---|---|---|---|
Ulcer | |||
Male sex | 1.71 | 1.12; 2.59 | 0.011 |
Smoking | 1.78 | 1.09; 2.89 | 0.019 |
Neuropathic foot | 9.96 | 4.85; 20.43 | <0.001 |
Ischemic foot | 5.64 | 1.9; 16.7 | 0.002 |
Neuroischemic foot | 20.34 | 9.31; 44.38 | <0.001 |
Decreased vibratory sensation | 1.36 | 0.82; 2.24 | 0.23 |
Absent vibratory sensation | 7.95 | 4.65; 13.59 | <0.001 |
Retinopathy | 1.68 | 1.08; 2.62 | 0.022 |
Region (South/Southeast) | 2.39 | 1.47; 3.87 | <0.001 |
Amputation | |||
Male sex | 2.12 | 1.2; 3.73 | 0.009 |
Type 2 diabetes | 3.33 | 1.01; 11.1 | 0.049 |
Neuropathic foot | 5.8 | 1.25; 26.9 | 0.025 |
Ischemic foot | 19.63 | 3.43; 112.5 | 0.001 |
Neuroischemic foot | 11.6 | 2.43; 55.33 | 0.002 |
Decreased vibratory sensation | 2.4 | 1.09; 5.3 | 0.03 |
Absent vibratory sensation | 3.46 | 1.64; 7.33 | 0.001 |
Hypertension | 0.3 | 0.14; 0.63 | 0.002 |
Region (South/Southeast) | 2.2 | 1.1; 4.42 | 0.027 |
Previous ulcer (yes) | 9.66 | 4.67; 19.98 | <0.001 |