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Diabetic charcot neuroarthropathy: prevalence, demographics and outcome in a regional referral centre

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Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Diabetic Charcot neuroarthropathy (DCN) is a devastating complication for people with diabetes mellitus. The failure to diagnose DCN and institute treatment in the acute phase leads to permanent deformity and significant morbidity. There is a paucity of data on the prevalence and characteristics of patients who have developed this complication of diabetes.

Aims

To determine the prevalence, clinical characteristics and outcomes of patients with DCN from 2006 to 2012.

Methods

Case finding was performed by searching three independent lists for the period 2006–2012 including: SYNGO radiology database, HIPE database of hospital discharges, and, combined list from podiatry, endocrinology, vascular surgery and orthopaedic clinics. A consensus meeting with chart review was undertaken to confirm diagnosis of DCN. A proforma was completed from chart review to determine clinical characteristics, initial treatment and outcomes for patients with DCN.

Results

Forty cases of DCN were identified, resulting in an estimated period prevalence of 0.3 %. The majority of patients were male (68 %); most patients had T2DM (73 %). Mean ± SD for age was 58 ± 10 years and mean duration of diabetes was 15 ± 9 years. In the acute phase of DCN, offloading was performed in 50 %. Bisphosphonates were administered to 5 % and surgery undertaken in 5 % of cases. 38 % of patients developed subsequent foot ulceration and 20 % required amputation.

Conclusions

This is the first prevalence estimate of DCN in Ireland. These data suggest diagnosis of DCN is missed in the acute phase. There exists a significant risk of diabetic foot ulceration and amputation with DCN.

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Authors and Affiliations

  1. Department of Diabetes, St. Vincent’s University Hospital, Dublin, Ireland

    A. O’Loughlin & R. Canavan

  2. Department of Podiatry, St. Vincent’s University Hospital, Dublin, Ireland

    E. Kellegher & C. McCusker

Authors
  1. A. O’Loughlin
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  2. E. Kellegher
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  3. C. McCusker
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  4. R. Canavan
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Corresponding author

Correspondence to A. O’Loughlin.

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Funding

There was no funding obtained for this study.

Conflict of interest

No author has a conflict of interest to declare.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors. The project was reviewed by the institutional audit committee at St. Vincent’s University Hospital and approval was obtained to proceed with data collection.

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O’Loughlin, A., Kellegher, E., McCusker, C. et al. Diabetic charcot neuroarthropathy: prevalence, demographics and outcome in a regional referral centre. Ir J Med Sci 186, 151–156 (2017). https://doi.org/10.1007/s11845-016-1508-5

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  • DOI: https://doi.org/10.1007/s11845-016-1508-5

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