The epidemiology of foot lesions in diabetic patients aged 15-50 years.
All diabetic patients aged 15-50 years (n = 395) in the county of Umeå (population 118,500) were invited to have a standardized foot examination and 380 (96%) attended. Three-quarters (78%) had Type 1 diabetes, 20% Type 2 diabetes, and 1% secondary diabetes. They were compared with 100 healthy control subjects. Both Type 1 and Type 2 diabetic patients had slight or moderate loss of forefoot arches more often than control subjects (57% and 60% vs 31%, p less than 0.001). Callosities were not significantly more common in diabetic patients than in control subjects. Lesions observed on the lower legs and feet of the Type 1 and Type 2 diabetic patients were Melin's shin spots (33% and 39%), dry feet (33% and 29%), yellow toenails (27% and 31%), purpura (9% and 5%), ulcers (3% and 0%), necrobiosis (3% and 0%), and diabetic osteopathy (2% and 0%). Intermittent claudication was present in 1% and 3%, respectively. Three Type 1 diabetic patients had undergone below-knee amputation. Two of the control subjects had Melin's shin spots. With the exception of necrobiosis which was only found in women with Type 1 diabetes and Melin's shin spots which were twice as common in diabetic men as women, whether Type 1 or Type 2, lesions were equally distributed between the sexes. Sensory thresholds for vibration, perception, and pain were significantly elevated in Type 1 diabetic patients with dry feet, fallen forefoot arches or hammer toes compared with those without. They were not increased in Type 2 diabetic patients or control subjects with these lesions.(ABSTRACT TRUNCATED AT 250 WORDS)
Borssén
B
B
Department of Orthopaedic Surgery, University of Umeå, Sweden.
Bergenheim
T
T
Lithner
F
F
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D001847:Bone Diseases / Q000453:epidemiology / Q000209:etiology; D003920:Diabetes Mellitus / Q000503:physiopathology*; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology; D005260:Female; D005528:Foot / Q000098:blood supply; D005534:Foot Diseases / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D012684:Sensory Thresholds; D012883:Skin Ulcer / Q000453:epidemiology / Q000209:etiology; D013548:Sweden