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Incidence of diabetic foot disorders in patients with diabetes in Jeddah, Saudi Arabia

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Abstract

Epidemiology of diabetic foot disorders in Saudi Arabia has not been well documented. We therefore performed a 1-year follow-up study to characterize the incidence of diabetic foot disorders, including peripheral arterial disease (PAD), peripheral neuropathy (PN), foot ulcer, gangrene, and amputation, among 556 diabetic patients in Saudi Arabia. All the disorders were diagnosed by standard objective diagnostic tools or diagnosed clinically by a specialized surgeon. Complication of foot ulcer (CFU) was defined as at least one of the following complications: foot ulcer, gangrene, and amputation. Diabetic foot disorder (DFD) was defined as at least one of the following complications: PAD, PN, foot ulcer, gangrene, and amputation. The 1-year cumulative incidence of PAD, PN, CFU, and DFD was 6.3, 9.2, 3.6, and 16.7 %, respectively. The 1-year cumulative incidence was 1.8 % for foot ulcer, 1.5 % for gangrene, and 0.6 % for amputation. Only one participant was diagnosed as more than one disorder. The longer duration of diabetes was associated with an increased incidence of PN and DFD. Relatively high incidences, as well as the duration of diabetes as the major risk factors for diabetic foot disorders were found in this Saudi population.

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References

  1. Boulton AJ, Vinik AI, Arezzo JC, Bril V, Feldman EL, Freeman R, et al. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care. 2005;28(4):956–62.

    Article  PubMed  Google Scholar 

  2. Hoyt RE. Peripheral arterial disease in people with diabetes: response to consensus statement. Diabetes Care. 2004;27(8):2095. author reply.

    Article  PubMed  Google Scholar 

  3. Lavery LA, Hunt NA, Lafontaine J, Baxter CL, Ndip A, Boulton AJ. Diabetic foot prevention: a neglected opportunity in high-risk patients. Diabetes Care. 2010;33(7):1460–2. doi:10.2337/dc10-0310.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Turner R, Holman R, Cull C, Stratton I, Matthews D, Frighi V, et al. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352(9131):837–53.

    Article  Google Scholar 

  5. New J, McDowell D, Burns E, Young R. Problem of amputations in patients with newly diagnosed diabetes mellitus. Diabet Med. 1998;15(9):760–4.

    Article  CAS  PubMed  Google Scholar 

  6. Schaper N, Andros G, Apelqvist J, Bakker K, Lammer J, Lepantalo M, et al. Diagnosis and treatment of peripheral arterial disease in diabetic patients with a foot ulcer. A progress report of the International Working Group on the Diabetic Foot. Diabetes Metab Res Rev. 2012;28(S1):218–24.

    Article  PubMed  Google Scholar 

  7. IDF. IDF Diabetes Atlas Sixth edition. 2013.

  8. Halawa MR, Karawagh A, Zeidan A, Mahmoud AE, Sakr M, Hegazy A. Prevalence of painful diabetic peripheral neuropathy among patients suffering from diabetes mellitus in Saudi Arabia. Curr Med Res Opin. 2010;26(2):337–43. doi:10.1185/03007990903471940.

    Article  PubMed  Google Scholar 

  9. Nasser J, Habib F, Yousef S. Prevalence of peripheral arterial disease among people attending diabetes clinics at primary care settings. Bahrain Medical Bulletin. 2011;33(4).

  10. Gordois A, Scuffham P, Shearer A, Oglesby A, Tobian JA. The health care costs of diabetic peripheral neuropathy in the US. Diabetes Care. 2003;26(6):1790–5.

    Article  PubMed  Google Scholar 

  11. Gregg EW, Sorlie P, Paulose-Ram R, Gu Q, Eberhardt MS, Wolz M, et al. Prevalence of lower-extremity disease in the US adult population ≥40 years of age with and without diabetes 1999–2000 National Health and Nutrition Examination Survey. Diabetes Care. 2004;27(7):1591–7.

    Article  PubMed  Google Scholar 

  12. Cuddy ML. Treatment of hypertension: guidelines from JNC 7 (the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure 1). J Pract Nurs. 2005;55(4):17–21. quiz 2–3.

    PubMed  Google Scholar 

  13. Greenland P, Abrams J, Aurigemma GP, Bond MG, Clark LT, Criqui MH, et al. Prevention Conference V: Beyond secondary prevention: identifying the high-risk patient for primary prevention: noninvasive tests of atherosclerotic burden: Writing Group III. Circulation. 2000;101(1):E16–22.

    Article  CAS  PubMed  Google Scholar 

  14. Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, et al. ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation. 2006;113(11):e463–654. doi:10.1161/circulationaha.106.174526.

    Article  PubMed  Google Scholar 

  15. Hoyer C, Sandermann J, Petersen LJ. The toe-brachial index in the diagnosis of peripheral arterial disease. J Vasc Surg. 2013;58(1):231–8. doi:10.1016/j.jvs.2013.03.044.

    Article  PubMed  Google Scholar 

  16. Bracewell N, Game F, Jeffcoate W, Scammell BE. Clinical evaluation of a new device in the assessment of peripheral sensory neuropathy in diabetes. Diabet Med. 2012;29(12):1553–5. doi:10.1111/j.1464-5491.2012.03729.x.

    Article  CAS  PubMed  Google Scholar 

  17. Kamei N, Yamane K, Nakanishi S, Yamashita Y, Tamura T, Ohshita K, et al. Effectiveness of Semmes-Weinstein monofilament examination for diabetic peripheral neuropathy screening. J Diabet Complicat. 2005;19(1):47–53. doi:10.1016/j.jdiacomp.2003.12.006.

    Article  Google Scholar 

  18. Jeffcoate WJ, Harding KG. Diabetic foot ulcers. Lancet. 2003;361(9368):1545–51.

    Article  PubMed  Google Scholar 

  19. Frykberg RG, Zgonis T, Armstrong DG, Driver VR, Giurini JM, Kravitz SR, et al. Diabetic foot disorders. A clinical practice guideline (2006 revision). J Foot Ankle Surg. 2006;45(5 Suppl):S1–S66. doi:10.1016/s1067-2516(07)60001-5.

    Article  PubMed  Google Scholar 

  20. Wattanakit K, Folsom AR, Selvin E, Weatherley BD, Pankow JS, Brancati FL, et al. Risk factors for peripheral arterial disease incidence in persons with diabetes: the Atherosclerosis Risk in Communities (ARIC) Study. Atherosclerosis. 2005;180(2):389–97. doi:10.1016/j.atherosclerosis.2004.11.024.

    Article  CAS  PubMed  Google Scholar 

  21. Adler AI, Boyko EJ, Ahroni JH, Stensel V, Forsberg RC, Smith DG. Risk factors for diabetic peripheral sensory neuropathy. Results of the Seattle Prospective Diabetic Foot Study. Diabetes Care. 1997;20(7):1162–7.

    Article  CAS  PubMed  Google Scholar 

  22. Boulton AJM, Vileikyte L, Ragnarson-Tennvall G, Apelqvist J. The global burden of diabetic foot disease. The Lancet.366(9498):1719–24. doi:http://dx.doi.org/10.1016/S0140-6736(05)67698-2.

  23. Moxey PW, Gogalniceanu P, Hinchliffe RJ, Loftus IM, Jones KJ, Thompson MM, et al. Lower extremity amputations—a review of global variability in incidence. Diabet Med. 2011;28(10):1144–53. doi:10.1111/j.1464-5491.2011.03279.x.

    Article  CAS  PubMed  Google Scholar 

  24. Chen HF, Ho CA, Li CY. Age and sex may significantly interact with diabetes on the risks of lower-extremity amputation and peripheral revascularization procedures: evidence from a cohort of a half-million diabetic patients. Diabetes Care. 2006;29(11):2409–14. doi:10.2337/dc06-1343.

    Article  PubMed  Google Scholar 

  25. McEwen LN, Ylitalo KR, Herman WH, Wrobel JS. Prevalence and risk factors for diabetes-related foot complications in Translating Research Into Action for Diabetes (TRIAD). J Diabet Complicat. 2013;27(6):588–92. doi:10.1016/j.jdiacomp.2013.08.003.

    Article  Google Scholar 

  26. Adler AI, Boyko EJ, Ahroni JH, Stensel V, Forsberg RC, Smith DG. Risk factors for diabetic peripheral sensory neuropathy: results of the Seattle Prospective Diabetic Foot Study. Diabetes Care. 1997;20(7):1162–7.

    Article  CAS  PubMed  Google Scholar 

  27. Dyck PJ, Davies JL, Clark VM, Litchy WJ, Klein CJ, Rizza RA, et al. Modeling chronic glycemic exposure variables as correlates and predictors of microvascular complications of diabetes. Diabetes Care. 2006;29(10):2282–8. doi:10.2337/dc06-0525.

    Article  PubMed  Google Scholar 

  28. Dyck PJ, Davies JL, Wilson DM, Service FJ, Melton 3rd LJ, O'Brien PC. Risk factors for severity of diabetic polyneuropathy: intensive longitudinal assessment of the Rochester Diabetic Neuropathy Study cohort. Diabetes Care. 1999;22(9):1479–86.

    Article  CAS  PubMed  Google Scholar 

  29. Sone H, Mizuno S, Yamada N. Vascular risk factors and diabetic neuropathy. N Engl J Med. 2005;352(18):1925–7. author reply −7.

    Article  PubMed  Google Scholar 

  30. De Block CE, De Leeuw IH, Van Gaal LF. Impact of overweight on chronic microvascular complications in type 1 diabetic patients. Diabetes Care. 2005;28(7):1649–55.

    Article  PubMed  Google Scholar 

  31. Al-Delaimy WK, Merchant AT, Rimm EB, Willett WC, Stampfer MJ, Hu FB. Effect of type 2 diabetes and its duration on the risk of peripheral arterial disease among men. Am J Med. 2004;116(4):236–40. doi:10.1016/j.amjmed.2003.09.038.

    Article  PubMed  Google Scholar 

  32. Camejo G, Olsson U, Hurt-Camejo E, Baharamian N, Bondjers G. The extracellular matrix on atherogenesis and diabetes-associated vascular disease. Atheroscler Suppl. 2002;3(1):3–9.

    Article  CAS  PubMed  Google Scholar 

  33. Morbach S, Lutale JK, Viswanathan V, Mollenberg J, Ochs HR, Rajashekar S, et al. Regional differences in risk factors and clinical presentation of diabetic foot lesions. Diabet Med. 2004;21(1):91–5.

    Article  CAS  PubMed  Google Scholar 

  34. Boulton AJ, Kirsner RS, Vileikyte L. Clinical practice. Neuropathic diabetic foot ulcers. N Engl J Med. 2004;351(1):48–55. doi:10.1056/NEJMcp032966.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by the Mohammad Hussein Al-Amoudi Chair for Diabetic Foot Research, King Abdulaziz University, Jeddah, Saudi Arabia.

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Authors and Affiliations

  1. The Department of Surgery and the Mohammad Hussein Al Amoudi Chair for Diabetic Foot Research, Faculty of Medicine, King Abdulaziz University, Jeddah, 21589, Saudi Arabia

    Hasan A. Alzahrani

  2. The Department of Nutrition, Harvard School of Public Health, Boston, MA, 02115, USA

    Dong Wang

  3. The Mohammad Hussein Al Amoudi Chair for Diabetic Foot Research, Faculty of Medicine, King Abdulaziz University, Jeddah, 21589, Saudi Arabia

    Almad H. Alzahrani

  4. Department of Physiology, Faculty of Medicine, Hail University, Hail, 81451, Saudi Arabia

    Almad H. Alzahrani

  5. Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Frank B. Hu

  6. The Channing Division for Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, 02115, USA

    Frank B. Hu

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  1. Hasan A. Alzahrani
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  2. Dong Wang
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Correspondence to Hasan A. Alzahrani or Frank B. Hu.

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Alzahrani, H.A., Wang, D., Alzahrani, A.H. et al. Incidence of diabetic foot disorders in patients with diabetes in Jeddah, Saudi Arabia. Int J Diabetes Dev Ctries 35, 115–122 (2015). https://doi.org/10.1007/s13410-014-0272-1

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  • DOI: https://doi.org/10.1007/s13410-014-0272-1

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