Journal
JOURNAL OF DIABETES AND ITS COMPLICATIONS
Volume 27, Issue 6, Pages 588-592Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jdiacomp.2013.08.003
Keywords
Charcot; Foot ulcer; Amputation; Diabetes
Categories
Funding
- Centers for Disease Control and Prevention (Division of Diabetes Translation)
- National Institute of Diabetes and Digestive and Kidney Diseases [P30DK09292601]
- Biostatistics Core of the Michigan Diabetes Research and Training Center [P60DK020572]
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Aims: The objective was to describe the prevalence of diabetes-related foot complications in a managed care population and to identify the demographic and biological risk factors. Methods: We assessed the period prevalence of foot complications on 6992 patients using ICD-9 diagnosis codes from health plan administrative data. Demographic and biological variables were ascertained from surveys and medical record reviews. We defined four mutually exclusive groups: any Charcot foot, DFU with debridement, amputation DFU and debridement, and no foot conditions. Results: Overall, 55 (0.8%) patients had Charcot foot, 205 (2.9%) had DFU with debridement, and 101 (1.4%) had a lower-extremity amputation. There were 6631 patients with no prevalent foot conditions. Racial/ethnic minorities were less likely to have Charcot foot (OR = 0.21; 95% CI: 0.10, 0.46) or DFU (OR = 0.61; 95% CI: 0.44, 0.84) compared to non-Hispanic Whites, but there were no racial/ethnic differences in amputation. Histories of micro- or macrovascular disease were associated with a two- to four-fold increase in the odds of foot complications. Conclusion: In managed care patients with uniform access to health care, we found a relatively high prevalence of foot complications, but attenuation of the racial/ethnic differences of rates reported in the literature. (C) 2013 Elsevier Inc. All rights reserved.
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