Title:Prevalence of Foot Ulcers, Foot at Risk and Associated Risk Factors Among Jordanian Diabetics
VOLUME: 13 ISSUE: 2
Author(s):Musab Yousef AlAyed, Nidal Younes, Moath Al-Smady, Yousef Saleh Khader, Asirvatham Alwin Robert and Kamel Ajlouni
Affiliation:Endocrinology and Diabetes Department, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh 11159,, National Center of Diabetes, Endocrinology and Genetics, Amman,, National Center of Diabetes, Endocrinology and Genetics, Amman,, Department of Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid,, Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh,, National Center of Diabetes, Endocrinology and Genetics, Amman
Keywords:Diabetes mellitus, foot ulcer, diabetes complication, risk factors, foot infections, Jordan.
Abstract:Objective: To examine the prevalence of foot ulcers, foot at risk, and the associated risk
factors among Jordanian diabetics.
Methods: A cross-sectional design was applied on 1000 diabetes patients (both type-1 and type-2)
aged >20 years. The participants were selected systematically from among every second patient visiting
the diabetes clinics at National Center for Diabetes, Endocrinology, and Genetics (NCDEG) in
Amman, Jordan. The participants were interviewed, examined, and then their medical records were
reviewed. The factors including sensory neuropathy, vibratory neuropathy, painful neuropathy, vascular
insufficiency, retinopathy, and dermatological changes were recorded for all patients. Foot at
risk was identified based on the risk category classification and foot ulcers were evaluated based on
the Wagner’s classification system.
Results: A total of 53 (5.3%) patients had foot ulcers, 17 (1.7%) had undergone amputations, and
172 (17.2%) had foot at risk. A total of 62 patients were identified in the risk category-1, 82 in the
risk category-2, and 28 in the risk category-3. Loss of protective sensation was detected in 174
(17.4%) patients, loss of vibratory sensation in 162 (16.2%) patients, absence of posterior tibial pulse
in 115 (11.5%) patients, absence of dorsalis pedis pulse in 97 (9.7%) patients, and claudication in 72
(7.2%) patients. Loss of protective sensation (p < 0.000), loss of vibratory sensation (p < 0.039), and
vascular insufficiency (p = 0.02) were found to be significantly higher in diabetic patients with foot
ulcers than in those without foot ulcers.
Conclusion: The prevalence of foot ulcer in Jordan was 5.3%, while foot at risk was prevalent in
17.2% patients. Patients with loss of protective sensation, loss of vibratory sensation, and vascular
insufficiency of the lower limbs were found to be at a higher risk for the development of foot ulceration.
