ABSTRACT
BACKGROUND: Diabetic Charcot neuroarthropathy (DCN) is a devastating complication for people with diabetes mellitus. The failure to diagnose DCN and institute treatment in the acute phase leads to permanent deformity and significant morbidity. There is a paucity of data on the prevalence and characteristics of patients who have developed this complication of diabetes. AIMS: To determine the prevalence, clinical characteristics and outcomes of patients with DCN from 2006 to 2012. METHODS: Case finding was performed by searching three independent lists for the period 2006-2012 including: SYNGO radiology database, HIPE database of hospital discharges, and, combined list from podiatry, endocrinology, vascular surgery and orthopaedic clinics. A consensus meeting with chart review was undertaken to confirm diagnosis of DCN. A proforma was completed from chart review to determine clinical characteristics, initial treatment and outcomes for patients with DCN. RESULTS: Forty cases of DCN were identified, resulting in an estimated period prevalence of 0.3 %. The majority of patients were male (68 %); most patients had T2DM (73 %). Mean ± SD for age was 58 ± 10 years and mean duration of diabetes was 15 ± 9 years. In the acute phase of DCN, offloading was performed in 50 %. Bisphosphonates were administered to 5 % and surgery undertaken in 5 % of cases. 38 % of patients developed subsequent foot ulceration and 20 % required amputation. CONCLUSIONS: This is the first prevalence estimate of DCN in Ireland. These data suggest diagnosis of DCN is missed in the acute phase. There exists a significant risk of diabetic foot ulceration and amputation with DCN.
