Neurosciences, Clinical Effectiveness, and Public Health Research Group, Universidad Cientifica del Sur, Lima, Peru.
Endocrinology Service, Department of Medicine, Hospital Maria Auxiliadora, Lima, Peru.
Rev Diabet Stud. 2022 Mar 9;18(1):1-9. doi: 10.1900/RDS.2022.18.1.
To assess the prevalence of patients at risk of developing diabetic foot complications(i.e.foot at-risk) and its clinical components according to the updated International Working Group on Diabetic Foot (IWGDF) criteria and to describe demographic and diabetes-related characteristics. We conducted a cross-sectional study at María Auxiliadora Hospital between 2017 and 2018. The criteria for foot at-risk in the IWGDF 2019 risk stratification system are classified into four risk categories, R0-R3, ranging from no peripheral arterial disease (PAD) and no peripheral neuropathy (PN) to the presence of PAD or PN in combination with previous foot ulcer, amputation, or end- stage renal disease (R3). According to this system, we obtained prevalence ratios (PR) of foot at-risk categories dependent on sex, age, diabetes duration, and Total Symptom Score. A sample size of 402 subjects was included in the study. Subjects included had a mean age of 61 years, and 66% were female. There were no patients with type 1 diabetes, and 59% percent had a diabetes duration of less than ten years. The prevalence of foot at-risk was 54.3% defined by the IWGDF 2019 criteria, which gave prevalence17% higher than that defined with the previous 1999 criteria. PN and PAD frequency was 37.3% and 30.1%, respectively. Foot at-risk prevalence was 40% higher in those with severe Total Symptom Score (PR 1.40, 95% CI 1.09-1.80) and also 39% higher in men than in women (PR 1.39, 95% CI 1.17-1.64). Likewise, diabetes duration of more than ten years had a 25% higher prevalence of foot at-risk (PR 1.25, 95% CI 1.05-1.49), and those older than 60 years had a 20% higher presence of this condition (PR 1.20, 95% CI 1.0011.43). Our hospital faces a substantial burden of diabetic foot risk in men, patients with long diabetes duration, and those with painful neuropathy. More initiatives are required at primary or hospital level to detect this critical condition. Likewise, reference centers with multidisciplinary teams to apply prevention and therapeutic interventions are urgently needed.
评估患有糖尿病足并发症风险的患者（即足部风险）及其临床成分的患病率，这些患者是根据最新的国际糖尿病足工作组（IWGDF）标准确定的，并描述人口统计学和糖尿病相关特征。我们在 2017 年至 2018 年期间在玛丽亚·阿苏利达医院进行了一项横断面研究。IWGDF 2019 风险分层系统中的足部风险标准分为四个风险类别，R0-R3，范围从无外周动脉疾病（PAD）和无周围神经病变（PN）到存在 PAD 或 PN 以及先前的足部溃疡、截肢或终末期肾病（R3）。根据该系统，我们获得了根据性别、年龄、糖尿病病程和总症状评分的足部风险类别的患病率比（PR）。研究纳入了 402 名受试者。受试者的平均年龄为 61 岁，66%为女性。没有 1 型糖尿病患者，59%的患者糖尿病病程小于 10 年。根据 IWGDF 2019 标准，足部风险的患病率为 54.3%，比以前的 1999 标准高 17%。PN 和 PAD 的频率分别为 37.3%和 30.1%。总症状评分严重的患者足部风险的患病率高 40%（PR1.40，95%CI1.09-1.80），男性比女性高 39%（PR1.39，95%CI1.17-1.64）。同样，糖尿病病程超过 10 年的患者足部风险的患病率高 25%（PR1.25，95%CI1.05-1.49），年龄大于 60 岁的患者足部风险的患病率高 20%（PR1.20，95%CI1.0011.43）。我们医院面临着男性、糖尿病病程长和有疼痛性神经病变的糖尿病足风险的巨大负担。需要在初级或医院层面采取更多措施来发现这种危急情况。同样，迫切需要有跨学科团队的参考中心来实施预防和治疗干预。
