Alonso-Fernández Margarita, Mediavilla-Bravo José Javier, López-Simarro Flora, Comas-Samper José Manuel, Carramiñana-Barrera Francisco, Mancera-Romero José, de Santiago Nocito Ana
Centro de Salud de La Eria, Oviedo, Asturias, España.
Centro de Salud Burgos Rural, Burgos, España.
Endocrinol Nutr. 2014 Jun-Jul;61(6):311-7. doi: 10.1016/j.endonu.2014.01.007. Epub 2014 Feb 25.
To ascertain whether patients with type 2 diabetes are screened for diabetic foot, and to analyze the factors related to patients and centers associated to performance of such screening.
A multicenter, epidemiological, cross-sectional study was conducted. The clinical records of 443 patients with type 2 diabetes monitored at Primary Care for at least 12 months were reviewed. Demographic and healthcare variables and characteristics of the primary care center were recorded.
In the previous year, 51.2% of patients had been trained on foot self-care, 56.4% had undergone foot inspection, 39.5% had been examined with a monofilament, and palpation of peripheral pulses and measurement of the ankle-brachial index were performed in 45.8 and 10.1% of patients, respectively. Diabetic foot screening (inspection, monofilament testing, and palpation of peripheral pulses) was performed in 37% of study patients. Ulcer risk stratification was done in 12.4% of patients. A significant association was found between diabetic foot screening and presence of foot deformities (P<.001), history of neuropathy (P=.005), and history of peripheral artery disease (P<.05). Screening was also associated to some characteristics of the center, such as reception of information about goal achievement (P<.001) and economic incentives for goal attainment (P<.001).
Compliance with diabetic foot screening and ulcer risk stratification in patients with type 2 diabetes in Primary Care was poor.
确定2型糖尿病患者是否接受糖尿病足筛查，并分析与患者及进行此类筛查的中心相关的因素。
开展了一项多中心、流行病学横断面研究。回顾了在基层医疗中接受至少12个月监测的443例2型糖尿病患者的临床记录。记录了人口统计学和医疗保健变量以及基层医疗中心的特征。
在上一年，51.2%的患者接受了足部自我护理培训，56.4%的患者接受了足部检查，39.5%的患者接受了单丝检查，分别有45.8%和10.1%的患者进行了外周脉搏触诊和踝臂指数测量。37%的研究患者进行了糖尿病足筛查（检查、单丝测试和外周脉搏触诊）。12.4%的患者进行了溃疡风险分层。发现糖尿病足筛查与足部畸形的存在（P<0.001）、神经病变史（P=0.005）和外周动脉疾病史（P<0.05）之间存在显著关联。筛查还与中心的一些特征相关，如关于目标达成的信息接收（P<0.001）和目标达成的经济激励（P<0.001）。
基层医疗中2型糖尿病患者对糖尿病足筛查和溃疡风险分层的依从性较差。
