Diabetic foot risk factors in diabetes type 1 patients

Abstract

Introduction. Patients with type 1 diabetes such as patients with type 2 diabetes are at risk of diabetic foot (DF) occurrence. DF risk factors in patients with type 2 diabetes were identified in many studies. There is a necessity to identify specifi c DF risk and protective factors for patients with type 1 diabetes because of differences in etiological background between type 1 and type 2 diabetes. The aim of the study was to assess risk and protective factors for diabetic foot occurrence in patients with type 1 diabetes.

Materials and methods. We included 58 patients with type 1 diabetes, 25 with diabetic foot and 33 without. The study was performed in Department of Gastroenterology and Metabolic Diseases, Medical University of Warsaw. We used logistic regression models, U Mann-Whitney test, t-Student test in STATISTICA 9PL (StatSoft) software.

Results. Duration of diabetes increases the risk of DF occurrence in patients with type 1 diabetes in logistic regression model by 8% per each year of diabetes (mean25.1 vs. 14.97 years, p = 0.002; OR = 1.08, 95% CI: 1.02–1.14, SD = 12.37). Mean age of diabetes diagnosis was lower in study group (mean 24.49 vs. 53.67 years, p = 0.0001; OR = 0.89, 95% CI: 0.84–0.94). The influence of age seems to be a factor decreasing the risk of DF occurrence by 7,5% per each year (mean 49.59 vs. 70.11 years, p = 0.00001, OR = 0.93; 95% CI: 0.89–0.97, SD = 18.83). Surprisingly, tobacco smoking was less often present in study group (p = 0.03, OR = 0.23; 95% CI: 0.06–0.88). We did not fi nd such relationship for pack-years count. Microangipathic complications were more often present in patients with DF: nephropathy (p = 0.0004), end-stage renal failure (p = 0.04) under dialysis and retinopathy (p = 0.00001).

Conclusion. The age is a protective factor for the occurrence of DF (the latter the onset of diabetes the lower the risk of DF). It is suspected that the background of these relationship lays among others in genetic variations. Duration of diabetes increases the risk of DF. Tobacco consumption as a protective factor seems to be controversial, needs to be verifi ed on larger groups of patients. We did not identifi ed common DF risk factors (typical for type 2 diabetes) such as height, weight or male gender which confi rms different aetiopathogenesis of its complication in patients with type 1 diabetes.