Predictors of Foot Ulcers Among Diabetic Patients at a Tertiary Care Center, Egypt

Background and Purpose: Diabetic foot ulcers (DFUs) markedly contribute to morbidity and mortality of diabetic patients. Hence, this study was conducted to investigate the predictors of foot ulcers among Egyptian diabetic patients. Methods: A case-control study was conducted among 488 diabetic patients attending the inpatient departments and outpatient clinics at the National Diabetes Institute in Egypt. A pretested data collection sheet was designed to collect and record the following: sociodemographic data, diabetic history and lifestyle characteristics, recorded comorbidities, and the results of foot examination. Results: Significant positive predictors of DFUs on multivariate logistic regression analysis included presence of three or more comorbidities; two or more diabetic complications; callus; and flatfoot. Significant protective (negative) predictors were management of diabetes by diet, oral hypoglycemic drugs (OHGs), and insulin; and intact vibration sense. Conclusion: Significant positive predictors of DFUs on multivariate analysis were presence of three or more comorbidities, two or more diabetic complications, callus and flatfoot, while protective predictors were management of diabetes by diet, OHGs, and insulin; and intact vibration sense. Hence, close monitoring should be provided to diabetic patients with comorbidities and complications to reduce the risk of DFUs.

Automated summary

This study investigated the predictors of foot ulcers among Egyptian diabetic patients, revealing that having three or more comorbidities, two or more diabetic complications, callus, and flatfoot are significant positive predictors of DFUs, while managing diabetes through diet, oral hypoglycemic drugs, and insulin, as well as intact vibration sense, were found to be protective predictors against DFUs. Close monitoring of diabetic patients with comorbidities and complications is recommended to reduce the risk of DFUs.