Foot ulceration in patients with diabetes: a risk analysis

Br J Nurs. 2017 Mar 23;26(6):S6-S14. doi: 10.12968/bjon.2017.26.6.S6.

Abstract

The study reported in this article aimed to analyse factors associated with the risk of ulceration in the feet of patients with diabetes using a conceptual hierarchic model. It was a cross-sectional study carried out with 1515 people with diabetes mellitus aged 40 years and older. The risk of foot ulceration was of higher significance in male patients with diabetes (adjusted odds ratio (OR)=1.39 (95% confidence interval (CI) 1.11 to 1.73); p=0.020), who did not practise a regular physical activity (adjusted OR=1.58 (95% CI 1.15 to 2.15); p=0.013), with time since diagnosis over 10 years (adjusted OR=1.42 (95% CI 1.10 to 1.86); p=0.011), who used insulin (adjusted OR=1.40 (95% CI 1.09 to 1.84); p=0.012), with retinopathy (adjusted OR=1.84 (95% CI 1.38 to 2.45); p=0.001) and who had had a previous stroke (adjusted OR=1.47 (95% CI 1.09 to 2.04); p=0.018). Mycosis on the nails and the interdigital spaces of the feet was statistically associated with ulceration risk independent of other variables of the model (adjusted OR=2.48 (95%CI 1.70 to 3.63); p=0.001). Finding the factors associated with ulceration contributes to the provision of quality care by nurses.

Keywords: Diabetes complications; Diabetes mellitus; Diabetic foot; Nursing; Self-care.

MeSH terms

  • Adult
  • Aged
  • Brazil / epidemiology
  • Cross-Sectional Studies
  • Dermatomycoses / epidemiology
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetic Foot / epidemiology*
  • Diabetic Foot / etiology
  • Diabetic Retinopathy / epidemiology*
  • Diabetic Retinopathy / etiology
  • Exercise*
  • Female
  • Foot Dermatoses / epidemiology
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / therapeutic use*
  • Male
  • Middle Aged
  • Odds Ratio
  • Onychomycosis / epidemiology
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Stroke / epidemiology*
  • Time Factors

Substances

  • Hypoglycemic Agents
  • Insulin