Risk factors for diabetic foot ulcers in type 2 diabetes: a case control study, Nyeri, Kenya

Abstract

People with diabetes have a significantly higher risk of foot ulceration, making foot complications one of the most frequent reasons for hospitalisation. We conducted a case control study with 60 diabetes patients with foot ulcers recruited as cases, and 120 diabetes patients without foot ulcers as controls. Odds ratios were calculated as measures of association for demographic, clinical, and behavioural risk factors. Stratified analysis and logistic regression were carried out. Glycaemic control, nail care, and adherence to medication were poor among the cases. Calluses on the feet (OR 3.7) and a blood pressure (BP) above 130/80 (OR 3.05) elevated risk of developing foot ulcers, while appropriate shoes (OR 0.43), examining feet regularly (OR 0.134) and having a prescribed diet and exercise plan (OR 0.30) conferred protection from foot ulcers. No fungal infections (OR 0.2) and having appropriate foot care education (OR 0.30) were significant protective factors specifically among males and females respectively. Many risk factors for diabetic foot ulceration are amenable to diabetes healthcare intervention.