Repetitive ulceration in neuropathic patients

Diabetes Metab Res Rev. May-Jun 2004;20 Suppl 1:S23-8. doi: 10.1002/dmrr.446.


Methods: In a retrospective study, 83 patients with diabetic neuropathic foot ulceration were classified into two groups: those with a higher rate of ulceration defined as >/=3.5 ulcers per foot per 10 years (group H) and those with a lower rate of <3.5 ulcers per foot per 10 years (group L).

Results: Higher risk was associated with neuroarthropathy, higher mean HbA(1c), men who lived alone, alcohol misuse by men, poor compliance with footwear, footcare and with non-foot aspects of diabetic self-care, higher non-attendance rates and, in patients with type 1 diabetes, delay in reporting new foot problems.

Conclusions: Reduction in ulcer recurrence rates will require improved orthotic provision in patients with neuroarthropathy and new methods to achieve behavioural change in other higher risk patients.

MeSH terms

  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / psychology
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / psychology
  • Diabetic Neuropathies / epidemiology*
  • Female
  • Foot Ulcer / epidemiology*
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Shoes
  • Treatment Refusal


  • Glycated Hemoglobin A