Kam Ming Long, Yap Yae Tyug, Kok Hoong Kooi, Seevasoothy Kishan Rasiah, Lim Yan Siew, Hong Ming Yen, Ibrahim Mohamad Izani, Thiruselvam Tharumaraja
Orthopaedics, Hospital Raja Permaisuri Bainun, Ipoh, MYS.
Pharmacy, Hospital Raja Permaisuri Bainun, Ipoh, MYS.
Cureus. 2025 Jun 10;17(6):e85708. doi: 10.7759/cureus.85708. eCollection 2025 Jun.
Charcot foot is a debilitating complication of diabetes mellitus (DM), characterized by joint destruction, deformity, and instability due to neuropathy-induced microtrauma. Despite its severe impact on mobility and quality of life, Charcot foot remains underdiagnosed. This study aims to determine the prevalence of Charcot foot among diabetic patients at two major referral hospitals in Malaysia and identify associated risk factors.
A cross-sectional study was conducted at the Integrated Diabetic Centers (IDCs) of Hospital Kulim and Hospital Raja Permaisuri Bainun (HRPB). Diabetic patients aged ≥18 years attending follow-ups at these centers were recruited via convenient sampling. Data collection included structured interviews, clinical examinations, laboratory investigations, and radiographic assessments. The diagnosis of Charcot foot was confirmed based on clinical findings, imaging, and laboratory parameters. Statistical analyses, including Fisher's exact test, were conducted using IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk, New York, United States), with significance set at p<0.05.
A total of 675 diabetic patients were included, with a mean age of 56.1 years (SD±13.96). Men comprised 58.2% (n=393/675) of participants, while 41.8% (n=282/675) were women. The overall prevalence of Charcot foot among diabetic patients in this study was 1.8% (n=12/675). Gender was significantly associated with Charcot foot (p=0.005), with a higher prevalence among women (3.5%; n=10/282) than men (0.5%; n=2/393). The mean DM duration among Charcot foot patients was 19.67 years (SD±7.34), with 66.7% (n=8/12) having DM for 11-20 years. Poor glycemic control was prevalent, with a mean HbA1c of 9.21% (SD±1.87) and 75% (n=9/12) of Charcot foot patients having HbA1c ≥7%. Additionally, 50% (n=6/12) had a history of diabetic foot ulcers, and 16.7% (n=2/12) had undergone prior amputation.
Charcot foot is a significant but often underdiagnosed complication in diabetic patients, particularly in women and those with long-standing, poorly controlled DM. Early detection and multidisciplinary management are crucial to reducing morbidity. Future research should focus on longitudinal studies to assess disease progression and intervention effectiveness.
夏科氏足是糖尿病（DM）的一种使人衰弱的并发症，其特征是由于神经病变引起的微创伤导致关节破坏、畸形和不稳定。尽管它对活动能力和生活质量有严重影响，但夏科氏足仍未得到充分诊断。本研究旨在确定马来西亚两家主要转诊医院糖尿病患者中夏科氏足的患病率，并确定相关危险因素。
在居林医院和拜农王后医院（HRPB）的综合糖尿病中心（IDCs）进行了一项横断面研究。通过方便抽样招募了在这些中心接受随访的年龄≥18岁的糖尿病患者。数据收集包括结构化访谈、临床检查、实验室检查和影像学评估。根据临床发现、影像学和实验室参数确诊夏科氏足。使用IBM SPSS Statistics for Windows 20.0版（IBM公司，美国纽约州阿蒙克）进行统计分析，包括Fisher精确检验，显著性设定为p<0.05。
共纳入675例糖尿病患者，平均年龄为56.1岁（标准差±13.96）。男性占参与者的58.2%（n=393/675），女性占41.8%（n=282/675）。本研究中糖尿病患者夏科氏足的总体患病率为1.8%（n=12/675）。性别与夏科氏足显著相关（p=0.005），女性患病率（3.5%；n=10/282）高于男性（0.5%；n=2/393）。夏科氏足患者的平均糖尿病病程为19.67年（标准差±7.34），66.7%（n=8/12）的患者糖尿病病程为11至20年。血糖控制不佳很普遍，夏科氏足患者的平均糖化血红蛋白为9.21%（标准差±1.87），75%（n=9/12）的患者糖化血红蛋白≥7%。此外，50%（n=6/12）有糖尿病足溃疡病史，16.7%（n=2/12）曾接受过截肢手术。
夏科氏足是糖尿病患者中一种重要但常未被充分诊断的并发症，尤其是在女性以及糖尿病病程长、血糖控制不佳的患者中。早期发现和多学科管理对于降低发病率至关重要。未来的研究应侧重于纵向研究，以评估疾病进展和干预效果。
