Risk factors of foot ulceration in patients with Diabetes Mellitus type 2

Authors

  • Patricia Bañuelos-Barrera RN, Ph.D. Professor Universidad Juárez del Estado de Durango -UJED-, Durango, México. email: pbanuelosb@hotmail.com.
  • Elva Dolores Arias-Merino Gerontologist, Ph.D. Professor Universidad de Guadalajara, Jalisco, México. email: elvadolores@yahoo.com.
  • Yolanda Banuelos-Barrera RN, Ph.D. Professor UJED, Durango, México. email: yobanuelos@gmail.com.

DOI:

https://doi.org/10.17533/udea.iee.17504

Keywords:

Foot ulcer; Diabetes Mellitus type 2; patient education as topic.

Abstract

Objective. Identify the risk factors for foot ulceration in patients with diabetes type 2 (DM2) who attended a primary care center in the city of Colima (Mexico).

 Methodology. This was a descriptive cross-sectional study conducted during 2012 with the participation of 87 patients with DM2 from both sexes and older than 30 years of age. Socio-demographic, anthropometric, clinical, and biochemical variables were measured. The study inquired about prior evaluation of the feet and prior education on diabetes by the healthcare team. 

Results. The mean age was 59 years and 70% were women. The average number of years since diagnosis was nine years; only 35% had good glycemia control; 66% engage in exercise; 51% wear open shoes; none had temperature differences in the feet; 82% had some type of dermatological abnormality; 50% had deformities in their feet. A total of 24% had been diagnosed with peripheral neuropathy and another 11% had peripheral vascular disease. Sixty percent of all the patients had risk of foot ulceration. Only 23% of the participants had had previous foot exams. One of every three diabetic patients had received education about the disease. 

Conclusion. An important proportion of the patients had risk of foot ulceration, contrary to the insufficient percentage of individuals with previous inspection and education about foot care. For nursing, it is an area of opportunity in this level of care to improve the inspection and education on diabetes, specifically on foot care, mainly in those patients with a prolonged evolution of the disease, deficient glycemia control, and risk of ulceration.

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References

(1) Cavanagh P, Attinger C, Abbas Z, Bal A, Rojas N, Xu Z. Cost of treating diabetic foot ulcers in five different countries. Diabetes Metab Res Rev. 2012; 28(Suppl 1):107-11.

(2) Lavery LA, Armstrong DG, Wunderlich RP, Tredwell J, Boulton AJ. Diabetic foot syndrome: Evaluating the prevalence and incidence of foot pathology in Mexican Americans and non-hispanics whites from a diabetes disease management cohort. Diabetes Care. 2003; 26(5):1435-38.

(3) International Working Group on the Diabetic Foot. Epidemiology of diabetic foot infections in a population based cohort. In: International Consensus on the Diabetic Foot; Noordwijkerhout, the Netherlands; May 22-24 2003.

(4) Lavery LA, Peters EJG, Armstrong DG. What are the most effective interventions in preventing diabetic foot ulcers? Int Wound J. 2008; 5:425-33.

(5) Reiber GE, Pecoraro RE, Koepsell TD. Risk factor for amputation in patient with diabetes mellitus: a case-control study. Ann Intern Med. 1992;117:97-105.

(6) International Working Group on the Diabetic Foot. Consultative section of the International Diabetes Federation. Practical guidelines on the management and prevention of the diabetic foot based upon the International Consensus on the diabetic foot. Amsterdam: International Diabetes Federation & International Working Group on the Diabetic Foot; 2007.

(7) American Diabetes Association. Executive Summary: Standards of medical care in diabetes 2013. Diabetes Care 2013; 36(S1):S4-S10.

(8) Gallagher D, Heymsfield SB, Heo M, Jebb SA, Murgtroyd PR, Sakamoto, Y. Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. Am J Clin Nutr. 2000; 72: 694-701.

(9) Singh N, Armstrong D, Lipsky B. Preventing foot ulcers in patients with diabetes. JAMA 2005; 293(2):217-28.

(10) Schaper NC, Andros G, Apelqvist J, Bakker K, Lammer J, Lepantalo M, et al. Specific guidelines for the diagnosis and treatment of peripheral arterial disease in a patient with diabetes and ulceration of the foot. Diabetes Metab Res Rev. 2012; 28(Suppl 1):236-37.

(11) Lavery LA, Higgins KR, Lanctot DR, Constantinides GP, Zamorano RG, Armstrong DG, et al. Home monitoring of foot skin temperatures to prevent ulceration. Diabetes Care. 2004; 17(11):2642-47.

(12) World Medical Association. Declaration of Helsinki: ethical principles for medical research involving human subjects. 2008 [cited 28 Jan 2010]. Available from: http://www.wma.net/e/policy/b3.htm.

(13) Aliss S, Cervantes R, Ibarra O, González B. Prevalencia de neuropatía periférica en diabetes mellitus. Acta Méd Grupo Ángeles. 2006; 4(1):13-7.

(14) Bruce S, Young T. Prevalence and risk factors for neuropathy in a Canadian first nation community. Diabetes Care. 2008; 31:1837-41.

(15) Bustos R, Prieto S. Factores de riesgo de ulceración de los pies en diabéticos tipo 2. Rev Med IMSS. 2009; 47(5):467-76.

(16) Ahn YB. Risk factors for foot ulceration in diabetic patients. J Korean Diabetes. 2011; 12:76-9.

(17) Monteiro-Soares M, Boyko EJ, Ribeiro J, Ribeiro I, Dinis-Ribeiro M. Risk stratification system for diabetic foot ulcers: A systematic review. Diabetologia. 2011; 54:1190-99.

(18) Peters EJG, Lavery LA. Effectiveness of the diabetic foot risk classification system of the International Working Group on the Diabetic Foot. Diabetes Care. 2001; 24(8):1442-47.

(19) Bower VM, Hobbs M. Validation of the basic foot screening checklist. A population screening tool for identifying foot ulcer risk in people with diabetes mellitus. J Am Podiatr Med Assoc. 2009; 99(4): 339-47.

(20) Ndip A, Lavery LA, LaFontaine J, Rutter MK, Vardhan A, Vileikyte L , et al. High levels of foot ulceration and amputation risk in a multiracial cohort of diabetic patient on dialysis therapy. Diabetes Care. 2010; 33(4):878-80.

(21) Leese GP, Freid F, Green V, Mcalpine R, Cunningham S, Emslie-Smith AM, et al. Stratification of foot ulcer risk in patient with diabetes: a population-based study. Int J Clin Pract. 2006; 60(5):541-45.

(22) Wylie RJ, Walker EA, Shamoon H, Engel S, Basch C, Zybert P. Assessment of documented foot examinations for patients with diabetes in inner-city primary care clinics. Arch Fam Med. 1995; 4(1):46-50.

(23) Edelson GW, Armstrong DG, Lavery LA, Caicco G. The acutely infected diabetic foot is not adequately evaluated in an inpatient setting. Arch Intern Med. 1996; 156(20): 2373-78.

(24) Lavery LA, Hunt NA, LaFontaine J, Baxter CL, Ndip A, Boulton AJM. Diabetic foot prevention. A neglected opportunity in high-risk patients. Diabetes Care. 2010;33(7):1460-62.

Published

2013-11-12

How to Cite

Bañuelos-Barrera, P., Arias-Merino, E. D., & Banuelos-Barrera, Y. (2013). Risk factors of foot ulceration in patients with Diabetes Mellitus type 2. Investigación Y Educación En Enfermería, 31(3). https://doi.org/10.17533/udea.iee.17504

Issue

Section

ORIGINAL ARTICLES / ARTÍCULOS ORIGINALES / ARTIGOS ORIGINAIS