A prospective study of risk factors for foot ulceration: The West of Ireland Diabetes Foot Study.

Hdl Handle:
http://hdl.handle.net/10147/302966
Title:
A prospective study of risk factors for foot ulceration: The West of Ireland Diabetes Foot Study.
Authors:
Hurley, L; Kelly, L; Garrow, Ap; Glynn, Lg; McIntosh, C; Alvarez-Iglesias, A; Avalos, G; Dinneen, Sf
Affiliation:
Diabetes Centre, Galway University Hospitals and Galway Primary Community and Continuing Care, Health Services Executive West.
Citation:
A prospective study of risk factors for foot ulceration: The West of Ireland Diabetes Foot Study. 2013: QJM
Journal:
QJM : monthly journal of the Association of Physicians
Issue Date:
25-Sep-2013
URI:
http://hdl.handle.net/10147/302966
DOI:
10.1093/qjmed/hct182
PubMed ID:
24072752
Abstract:
BackgroundThis is the first study to examine risk factors for diabetic foot ulceration in Irish general practice.AimTo determine the prevalence of established risk factors for foot ulceration in a community-based cohort, and to explore the potential for estimated glomerular filtration rate (eGFR) to act as a novel risk factor.DesignA prospective observational study.MethodsPatients with diabetes attending 12 (of 17) invited general practices were invited for foot screening. Validated clinical tests were carried out at baseline to assess for vascular and sensory impairment and foot deformity. Ulcer incidence was ascertained by patient self-report and medical record. Patients were re-assessed 18 months later. ResultsOf 828 invitees, 563 (68%) attended screening. On examination 23-25% had sensory dysfunction and 18-39% had evidence of vascular impairment. Using the Scottish Intercollegiate Guidelines Network risk stratification system we found the proportion at moderate and high risk of future ulceration to be 25% and 11% respectively. At follow-up 16/383 patients (4.2%) developed a new foot ulcer (annual incidence rate of 2.6%). We observed an increasing probability of abnormal vascular and sensory test results (pedal pulse palpation, doppler waveform assessment, 10g monofilament, vibration perception and neuropathy disability score) with declining eGFR levels. We were unable to show an independent association between new ulceration and reduced eGFR [Odds ratio 1.01; p=0.64].ConclusionsOur data show the extent of foot complications in a representative sample of diabetes patients in Ireland. Use of eGFR did not improve identification of patients at risk of foot ulceration.
Item Type:
Article
Keywords:
DIABETES
Local subject classification:
DIABETIC FOOT; ULCERATION
ISSN:
1460-2393

Full metadata record

DC FieldValue Language
dc.contributor.authorHurley, Len_GB
dc.contributor.authorKelly, Len_GB
dc.contributor.authorGarrow, Apen_GB
dc.contributor.authorGlynn, Lgen_GB
dc.contributor.authorMcIntosh, Cen_GB
dc.contributor.authorAlvarez-Iglesias, Aen_GB
dc.contributor.authorAvalos, Gen_GB
dc.contributor.authorDinneen, Sfen_GB
dc.date.accessioned2013-10-08T09:00:40Z-
dc.date.available2013-10-08T09:00:40Z-
dc.date.issued2013-09-25-
dc.identifier.citationA prospective study of risk factors for foot ulceration: The West of Ireland Diabetes Foot Study. 2013: QJMen_GB
dc.identifier.issn1460-2393-
dc.identifier.pmid24072752-
dc.identifier.doi10.1093/qjmed/hct182-
dc.identifier.urihttp://hdl.handle.net/10147/302966-
dc.description.abstractBackgroundThis is the first study to examine risk factors for diabetic foot ulceration in Irish general practice.AimTo determine the prevalence of established risk factors for foot ulceration in a community-based cohort, and to explore the potential for estimated glomerular filtration rate (eGFR) to act as a novel risk factor.DesignA prospective observational study.MethodsPatients with diabetes attending 12 (of 17) invited general practices were invited for foot screening. Validated clinical tests were carried out at baseline to assess for vascular and sensory impairment and foot deformity. Ulcer incidence was ascertained by patient self-report and medical record. Patients were re-assessed 18 months later. ResultsOf 828 invitees, 563 (68%) attended screening. On examination 23-25% had sensory dysfunction and 18-39% had evidence of vascular impairment. Using the Scottish Intercollegiate Guidelines Network risk stratification system we found the proportion at moderate and high risk of future ulceration to be 25% and 11% respectively. At follow-up 16/383 patients (4.2%) developed a new foot ulcer (annual incidence rate of 2.6%). We observed an increasing probability of abnormal vascular and sensory test results (pedal pulse palpation, doppler waveform assessment, 10g monofilament, vibration perception and neuropathy disability score) with declining eGFR levels. We were unable to show an independent association between new ulceration and reduced eGFR [Odds ratio 1.01; p=0.64].ConclusionsOur data show the extent of foot complications in a representative sample of diabetes patients in Ireland. Use of eGFR did not improve identification of patients at risk of foot ulceration.en_GB
dc.languageENG-
dc.rightsArchived with thanks to QJM : monthly journal of the Association of Physiciansen_GB
dc.subjectDIABETESen_GB
dc.subject.otherDIABETIC FOOTen_GB
dc.subject.otherULCERATIONen_GB
dc.titleA prospective study of risk factors for foot ulceration: The West of Ireland Diabetes Foot Study.en_GB
dc.typeArticleen
dc.contributor.departmentDiabetes Centre, Galway University Hospitals and Galway Primary Community and Continuing Care, Health Services Executive West.en_GB
dc.identifier.journalQJM : monthly journal of the Association of Physiciansen_GB
dc.description.fundingNo fundingen
dc.description.provinceConnachten
dc.description.peer-reviewpeer-reviewen

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