Risk assessment of patients with diabetes for foot ulcers according to risk classification consensus of international working group on diabetic foot [IWGDF]

ABSTRACT

The aim was assessment of diabetic foot ulcer risk factors according to International Working Group on the Diabetic Foot [IWGDF] consensus. All referred patients with diabetes were divided into four groups based on IWGDF criteria [without neuropathy, with neuropathy, neuropathy with deformity or vascular disorders, foot ulcer or amputation history]. Mean age of patients was 53.8 +/- 10.7 years. Two hundred and sixty nine patients [62/6%] were female and 161[37/4%] were male. Twenty three percent had disturbed sense of vibration, 26% had decreased sensitivity to monofilaments and 17% had decreased pain sensation. Ankle brachial index [ABI] was abnormal in 6%. About 7% had history of prior ulcer. Patients were classified into four risk groups according to IWGDF criteria. Two hundred and seventy seven patients [65%] were in group 0, 75[17%] in group 1, 47 [11%] in group 2 and 31 [7%] in group 3. Patients in higher-risk groups had higher age, longer diabetes duration, higher HbA1C and less training [p=0.0001, 0.001, 0.0001, 0.021 respectively]. The risk was higher in the presence of retinopathy [p=0.005]. Patient's sex, BMI, smoking and nephropathy did not have significant correlation with risk of diabetic foot ulcer. This study showed that increase of age, duration of diabetes and HbA1c, lack of training and presence of retinopathy increases the risk of diabetic foot ulcers