Chandalia H B, Singh D, Kapoor V, Chandalia S H, Lamba P S
Diabetes Endocrine Nutrition Management and Research Center (DENMARC), Mumbai, India.
Int J Diabetes Dev Ctries. 2008 Oct;28(4):109-13. doi: 10.4103/0973-3930.45269.
We assessed 300 diabetic and 100 age- and sex-matched controls for correlating foot wear practices and foot care knowledge and the presence of foot complications. A structured questionnaire evaluated the knowledge about foot care, type of footwear used, education level, association of tobacco abuse, and any associated symptoms of foot disease. Clinical evaluation was done by inspection of feet for presence of any external deformities, assessment of sensory function (vibration perception threshold, VPT), vascular status (foot pulses and ankle brachial ratio) and presence of any infection.In the diabetes category, 44.7% patients had not received previous foot care education. 0.6% walked barefoot outdoors and 45% walked barefoot indoors. Fourteen (4.7%) patients gave history of foot ulceration in the past and comprised the high risk group; only 2 out of 14 had received foot care education, 6 gave history of tobacco abuse, 8 had symptoms of claudication, 9 had paresthesias, 2 walked barefoot indoors. Average duration of diabetes in the high-risk and low-risk diabetes group was 10.85 +/- 6.53 and 9.83 +/- 7.99 years, respectively. In the high- and low-risk diabetic groups, VPT was 19.57 +/- 11.26 and 15.20 +/- 10.21V (P < 0.02), ankle brachial ratio was 1.05 +/- 0.19 and 1.14 +/- 0.18 (P < 0.05), and the questionnaire scores was 40.8% and 57%, respectively.In the diabetic and the control group, VPT was 15.62 +/- 10.39 and 8.36 +/- 3.61 V (P < 0.01), ankle brachial ratio was 1.14 +/- 0.18 and 1.15 +/- 0.12, and the questionnaire scores were 57% and 40.3%, respectively.In conclusion, poor knowledge of foot care and poor footwear practices were important risk factors for foot problems in diabetes.
我们评估了300名糖尿病患者以及100名年龄和性别匹配的对照者，以关联足部穿着习惯、足部护理知识以及足部并发症的存在情况。一份结构化问卷评估了有关足部护理的知识、所穿鞋子的类型、教育水平、烟草滥用情况以及足部疾病的任何相关症状。通过检查足部是否存在任何外部畸形、评估感觉功能（振动觉阈值，VPT）、血管状况（足部脉搏和踝臂指数）以及是否存在任何感染来进行临床评估。在糖尿病患者组中，44.7%的患者此前未接受过足部护理教育。0.6%的患者在户外赤脚行走，45%的患者在室内赤脚行走。14名（4.7%）患者有既往足部溃疡病史，构成高危组；14名患者中只有2名接受过足部护理教育，6名有烟草滥用史，8名有间歇性跛行症状，9名有感觉异常，2名在室内赤脚行走。高危糖尿病组和低危糖尿病组的糖尿病平均病程分别为10.85±6.53年和9.83±7.99年。在高危和低危糖尿病组中，VPT分别为19.57±11.26和15.20±10.21V（P<0.02），踝臂指数分别为1.05±0.19和1.14±0.18（P<0.05），问卷得分分别为40.8%和57%。在糖尿病组和对照组中，VPT分别为15.62±10.39和8.36±3.61V（P<0.01），踝臂指数分别为1.14±0.18和1.15±0.12，问卷得分分别为57%和40.3%。总之，足部护理知识匮乏和不良的足部穿着习惯是糖尿病患者足部问题的重要危险因素。
