Al-Rubeaan Khalid, Al Derwish Mohammad, Ouizi Samir, Youssef Amira M, Subhani Shazia N, Ibrahim Heba M, Alamri Bader N
University Diabetes Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Diabetic Foot Unit, University Diabetes Center, King Saud University, Riyadh, Saudi Arabia.
PLoS One. 2015 May 6;10(5):e0124446. doi: 10.1371/journal.pone.0124446. eCollection 2015.
Foot complications are considered to be a serious consequence of diabetes mellitus, posing a major medical and economical threat. Identifying the extent of this problem and its risk factors will enable health providers to set up better prevention programs. Saudi National Diabetes Registry (SNDR), being a large database source, would be the best tool to evaluate this problem.
This is a cross-sectional study of a cohort of 62,681 patients aged ≥ 25 years from SNDR database, selected for studying foot complications associated with diabetes and related risk factors.
The overall prevalence of diabetic foot complications was 3.3% with 95% confidence interval (95% CI) of (3.16%-3.44%), whilst the prevalences of foot ulcer, gangrene, and amputations were 2.05% (1.94%-2.16%), 0.19% (0.16%-0.22%), and 1.06% (0.98%-1.14%), respectively. The prevalence of foot complications increased with age and diabetes duration predominantly amongst the male patients. Diabetic foot is more commonly seen among type 2 patients, although it is more prevalent among type 1 diabetic patients. The Univariate analysis showed Charcot joints, peripheral vascular disease (PVD), neuropathy, diabetes duration ≥ 10 years, insulin use, retinopathy, nephropathy, age ≥ 45 years, cerebral vascular disease (CVD), poor glycemic control, coronary artery disease (CAD), male gender, smoking, and hypertension to be significant risk factors with odds ratio and 95% CI at 42.53 (18.16-99.62), 14.47 (8.99-23.31), 12.06 (10.54-13.80), 7.22 (6.10-8.55), 4.69 (4.28-5.14), 4.45 (4.05-4.89), 2.88 (2.43-3.40), 2.81 (2.31-3.43), 2.24 (1.98-2.45), 2.02 (1.84-2.22), 1.54 (1.29-1.83), and 1.51 (1.38-1.65), respectively.
Risk factors for diabetic foot complications are highly prevalent; they have put these complications at a higher rate and warrant primary and secondary prevention programs to minimize morbidity and mortality in addition to economic impact of the complications. Other measurements, such as decompression of lower extremity nerves, should be considered among diabetic patients.
足部并发症被认为是糖尿病的严重后果，构成了重大的医学和经济威胁。确定这一问题的严重程度及其风险因素将使医疗服务提供者能够制定更好的预防方案。沙特国家糖尿病登记处（SNDR）作为一个大型数据库来源，将是评估这一问题的最佳工具。
这是一项横断面研究，从SNDR数据库中选取了62681名年龄≥25岁的患者队列，用于研究与糖尿病相关的足部并发症及相关风险因素。
糖尿病足部并发症的总体患病率为3.3%，95%置信区间（95%CI）为（3.16%-3.44%），而足部溃疡、坏疽和截肢的患病率分别为2.05%（1.94%-2.16%）、0.19%（0.16%-0.22%）和1.06%（0.98%-1.14%）。足部并发症的患病率随年龄和糖尿病病程增加，在男性患者中尤为明显。糖尿病足在2型患者中更常见，尽管在1型糖尿病患者中更普遍。单因素分析显示夏科关节、外周血管疾病（PVD）、神经病变、糖尿病病程≥10年、使用胰岛素、视网膜病变、肾病、年龄≥45岁、脑血管疾病（CVD）、血糖控制不佳、冠状动脉疾病（CAD）、男性、吸烟和高血压是显著的风险因素，其比值比和95%CI分别为42.53（18.16-99.62）、14.47（8.99-23.31）、12.06（10.54-13.80）、7.22（6.10-8.55）、4.69（4.28-5.14）、4.45（4.05-4.89）、2.88（2.43-3.40）、2.81（2.31-3.43）、2.24（1.98-2.45）、2.02（1.84-2.22）、1.54（1.29-1.83）和1.51（1.38-1.65）。
糖尿病足部并发症的风险因素非常普遍；它们使这些并发症的发生率更高，除了并发症的经济影响外，还需要一级和二级预防方案来尽量减少发病率和死亡率。对于糖尿病患者，还应考虑其他措施，如下肢神经减压。
