|
Sign In to gain access to subscriptions and/or personal tools.
|
Scandinavian Journal of Public Health, Vol. 36, No. 1,
62-68 (2008)
DOI: 10.1177/1403494807085314
History of and factors associated with diabetic foot ulcers in Norway: The Nord-Trøndelag Health Study
Marjolein M. Iversen
Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway, marjolein.iversen{at}hib.no, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
Kristian Midthjell
The HUNT Research Center, Norwegian University of Science and Technology, Verdal, Norway
Truls Østbye
Department of Community and Family Medicine, Duke University Medical Center, Durham, USA
Grethe S. Tell
Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
Elizabeth Clipp
School of Nursing, Duke University Medical Center, Durham, USA
Richard Sloane
Department of Medicine, Division of Geriatrics, Duke University Medical Center, Durham, USA
Monica W. Nortvedt
Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway
Sverre Uhlving
Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway
Berit R. Hanestad
Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
Aims: To determine the proportion of people with diabetes mellitus reporting a history of foot ulcer and to investigate factors associated with this adverse outcome. Methods: All inhabitants aged 20 years and older residing in a large geographic region were invited to participate in the Nord-Trøndelag Health Study, 71% (n=65,604) attended. Those reporting diabetes (n=1,972) were invited to take part in an ancillary study on diabetes. Based on 1,494 responses to the question: ``Have you had a foot ulcer that required more than three weeks to heal'', the proportion with a history of foot ulcer was estimated. Results: The overall proportion with a history of foot ulcer was 10.4% (95% CI 8.8—11.9%). In the final multivariate logistic regression model, significant factors for a foot ulcer history included age  75 years (OR 1.8, 95% CI 1.2—2.8), height (men>175 cm, women>161 cm) (1.9, 95% CI 1.3—2.8), gender (male) (1.5, 95% CI 1.03—2.2), using insulin (1.6, 95% CI 1.1—2.4), and macrovascular complications (1.8, 95% CI 1.2—2.6). Conclusions: The proportion of people reporting a history of foot ulcer in this population-based study exceeded the proportion of foot ulcer history reported previously. Height as a correlate has been occasionally reported in previous studies and needs further attention. Associated factors for a foot ulcer history help identify individuals who may be at particular risk of this adverse outcome.
Key Words: Diabetes mellitus • foot ulcer • population study • risk factors
References
- Wild S., Roglic G., Green A., Sicree R., King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care 2004;27:1047—53.[Abstract/Free Full Text]
- Joner G., Stene LC, Søvik O. Nationwide, prospective registration of type 1 diabetes in children aged 15 years in Norway 1989—1998. Diabetes Care 2004;27:1618—22.[Abstract/Free Full Text]
- Midthjell K., Krüger Ø, Holmen J., Tverdal A., Claudi T., Bjørndal A., et al. Rapid changes in the prevalence of obesity and known diabetes in an adult Norwegian population. North-Trøndelag Health Surveys: 1984—1986 and 1995— 1997. Diabetes Care 1999;22:1813—20.[Abstract/Free Full Text]
- Apelqvist J., Larsson J. What is the most effective way to reduce incidence of amputation in the diabetic foot? Diab Metab Res Rev 2000;16(Suppl 1):575—83.
- Boulton AJM, Vileikyte L., Ragnarson-Tennvall G., Apelqvist J. The global burden of diabetic foot disease. Lancet 2005;366:1719—24.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Boyko EJ, Ahrohi JH, Stensil V., Forsberg RC, Davignon DR, Smith DG A prospective study of risk factors for diabetic foot ulcer. The Seattle Diabetic Foot Study. Diabetes Care 1999;22:1036—42.[Abstract/Free Full Text]
- Abbott CA, Carrington A.L., Ashe H., Baths S., Every LC, Griffiths J., et al. The North West Diabetes Foot Care Study: Incidence of, and risk factors for, new diabetic foot ulceration in a community based patient cohort. Diabet Med 2002;19:377—84.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- International Working Group on the Diabetic Foot. International Consensus on the Diabetic Foot: Practical guidelines. Noordwijkerhout: Author; 1999. p 20—1.
- Walters DP, Gatling W., Mullee MA, Hill RD The distribution and severity of diabetic foot disease: A community study with comparison to non-diabetic group. Diabet Med 1992;9:354—58.[ISI][Medline]
[Order article via Infotrieve]
- Tapp RJ, Shaw JE, de Courten MP, Dunstan DW, Welborn TA, Zimmet PZ Foot complications in Type 2 diabetes: An Australian population-based study. Diabet Med 2003;20:105—13.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Abbott CA, Garrow AP, Carrington AL, Morris J., Van Ross ER, Boulton AJ Foot Ulcer Risk Is Lower in South— Asian and African—Caribbean Compared With European Diabetic Patients in the U.K.: The North—West Diabetes Foot Care Study. Diabetes Care 2005;28:1869—75.[Abstract/Free Full Text]
- Holmen J., Midthjell K., Krüger Ø, Langhammer A., Holmen TL, Bratberg GH, et al. The Nord-Trøndelag Health Study 1995—97 (HUNT 2): Objectives, contents, methods and participation. Norsk Epidemiologi 2003;13: 19—32.
- Næss S., Eriksen J., Midthjell K., Tambs K. Diabetes mellitus and psychological well-being: Change between 1984—1986 and 1995—1997. Results of the Nord-Trøndelag Health Study. J Diab Compl 2004;18:141—7.
- Midthjell K., Holmen J., Bjørndal A., Lund-Larsen PG Is questionnaire information valid in the study of a chronic disease such as diabetes? The Nord-Trøndelag diabetes study. J Epid Comm Health 1992;46:537—42.[Abstract]
- World Health Organization, Definition, diagnosis and classification of diabetes mellitus and its complications, Part 1: Diagnosis and classification of diabetes mellitus. Geneva: WHO, Department of Noncommunicable Disease Surveillance; 1999.
- Hallan H., Romundstad S., Kvenild K., Holmen J. Microalbuminuria in diabetic and hypertensive patients and the general population consequences of various diagnostic criteria: The Nord-Trøndelag Health Study (HUNT). Scand J Uril Nephrol 2003;37:151—8.[CrossRef]
- Engum A., Mykltun A., Midthjell K., Holen A., Dahl AA Depression and diabetes: A large population-based study of sociodemographic, lifestyle, and clinical factors associated with depression in type 1 and type 2 diabetes. Diabetes Care 2005;28:1904—09.[Abstract/Free Full Text]
- Lean M., Han T., Morrison C. Waist circumference as a measure for indicating need for weight management. BMJ 19953;11:158—61.
- Lindstrøm J., Tuomilehto J. The diabetes Risk Score: A practical tool to predict type 2 diabetes risk. Diabetes Care 2003;26:725—31.[Abstract/Free Full Text]
- Lavery LA, Armstrong DG, Vela SA, Quebedeaux TL, Fleischli JG Practical criteria for screening patients at high risk for diabetic foot ulceration. Arch Intern Med 1998;158:157—62.[Abstract/Free Full Text]
- Mayfield JA, Reiber GE, Sanders LJ, Janisse D., Pogach LM Preventive foot care in diabetes. Diabetes Care 1998;21: 2161—77.[Abstract]
- American Diabetes Association, Standards of medical care in diabetes: Position Statement. Diabetes Care 2006;29: S4—S42.[Free Full Text]
- Robinson LR, Stolov WC, Rubner DE, Wahl PW, Leonetti DL, Fujimoto WY Height is an independent risk factor for neuropathy in diabetic men. Diab Res Clin Prac 1992;16:97—102.[CrossRef]
- De Berardis G., Pellegrini F., Franciosi M., Belfiglio M., di Nardo B., Greenfield S., et al. QuED Study Group —Quality of care and outcomes in Type 2 diabetes: Are Type 2 diabetic patients offered adequate foot care? The role of physician and patient characteristics. J Diabetes Complications 2005;19:319—27.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Mason J., O'Keeffe C., McIntosh A., Hutchinson A., Booth A., Young RJ A systematic review of foot ulcer in patients with Type 2 diabetes mellitus, I: Prevention. Diabet Med 1999;16:801—12.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- International DAWN Advisory Panel,, Peyrot M., Rubin RR, Lauritzen T., Skovlund SE, Snoek FJ, Mattheys DR, Landgraf R. Patient and provider perceptions of care for diabetes: Results of the cross-national DAWN study. Diabetiologia 2006;49:279—88.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Saaddine JB, Cadwell B., Gregg EW, Engelgau MM, Vinicor F., Imperatore G., Venkat Narayan KM Improvements in diabetes process of care and intermediate outcomes: United States, 1988—2002. Ann Intern Med 2006;144:465—74.[Abstract/Free Full Text]
- Burden M. Providing a diabetes foot care service. In: Boulton AJM, Connor H, Cavanagh PR, editors. The foot in diabetes. 3rd ed, Chichester: Wiley; 2001. p 73—80.
- Lavery LA, Wunderlich RP, Tredwell JL Disease management for the diabetic foot: Effectiveness of a diabetic foot prevention program to reduce amputations and hospitalizations. Diab Res Clin Pract 2005;70: 31—7.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
|
