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Multiple Complications Accompany Predominantly Neuroischaemic Foot Ulcers In Diabetics

Foot ulcers in diabetics are accompanied by multiple diabetic complications, over half of which are neuroischaemic ulcers.

Investigators from Manchester Royal Infirmary in Manchester, England, studied the clinical characteristics of patients with diabetic foot complications who had been admitted to the Manchester Diabetic Foot Clinic during a seven year period.

Patient demographics, referral source and reason for referral, previous amputations and diabetes complications at presentation were evaluated for 185 male and 113 female patients. Mean age of the patients was 62.5 ± 13.1 years, mean duration of their diabetes was 14.9 ± 11.6 years.

Type 2 diabetes was present in 73.8 percent of the patients, and 86.7 percent of the patients visited the clinic as a result of foot ulceration.

Ulcers were neuroischaemic in 52.3 percent of cases, most (76.7 percent) were located on the forefoot.

Clinical evidence of peripheral neuropathy was present in 80 percent of patients and peripheral arterial disease in 60 percent. Only one third of those with peripheral arterial disease were symptomatic. Seventy percent of patients had multiple diabetic complications.

Males were more likely than females to have hypertension (48.1 versus 32.1 percent) and previous amputation (15.2 versus 5.4 percent). Multiple foot ulcers were more common in females than males (21.5 percent versus 12.7 percent).

These characteristics may significantly influence treatment costs and mortality rates, the investigators concludes.
Pract Diabetes Int 2002; 19(1): 10-12. "Clinical characteristics of patients with diabetic foot problems: changing patterns of foot ulcer presentation"

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