[The "diabetic foot" syndrome. Association with other complications and the incidence of amputation].
BACKGROUND
Only few studies have investigated the incidence of foot lesions and amputation rate in diabetic patients.


METHODS
Thus, the 10-year incidence rates of first lower extremity amputation were studied in 560 diabetic patients, aged 35 to 55 years at baseline and followed up within the WHO-Multinational Study of Vascular Disease in Diabetes. Furthermore, we studied the frequency of other complications in 51 outpatients with "the diabetic foot syndrome".


RESULTS
In type 1 diabetic patients, the incidence rates (7.2/1,000 person-years for men and 7.6/1,000 person-years for women) were higher as compared with type 2 diabetic patients (4.1/1,000 and 4.3/1,000 per person-years for men and women, respectively). In multivariate analysis, duration of diabetes, hypertension, claudicatio intermittens, retinopathy and proteinuria emerged as potential risk factors. Outpatients with the "diabetic foot syndrome" were characterized by an advanced age and a long duration of diabetes (59 years and 22.5 years, respectively). 30 patients (58%) had type 1 diabetes and 21 (42%) had type 2, diabetes mellitus. The proportion of complications was as follows: foot lesions due to diabetic neuropathy or peripheral ischaemic vessel disease in 45.1% and 25.5%, and a combination of both in 29.4%. The majority of type 2 diabetic patients had lesions due to peripheral ischaemic vessel disease (77%); these patients were 10-years older as compared with patients with neuropathic lesions. Proliferative retinopathy was 4 times as high in patients with neuropathic lesions as compared with patients with ischaemic lesions (61% vs 15%).


CONCLUSIONS
The findings once again emphasize the importance of education and training programs in elderly diabetic patients.
Ehemaliges Institut für Diabetes und Stoffwechselkrankheiten, Berlin.
K P
KP
Ratzmann
E
E
Drzimalla
M
M
Raskovic
D000328:Adult; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D017719:Diabetic Foot / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
Das Syndrom des "diabetischen Fusses". Vergesellschaftung mit anderen Komplikationen sowie Inzidenz von Amputationen.