title: Quality of life and clinical correlates in patients with diabetic foot ulcers.
abstract: OBJECTIVE
  To compare the Health Related Quality of Life (HRQL) of French diabetic patients with and without foot ulcers and to determine the factors influencing disease-specific HRQL for those with foot ulcers.
  
  
  METHODS
  355 diabetic patients, including 239 with foot ulcers (group 1) and 116 without foot ulcers (group 2) were studied in a cross-sectional setting. Socio-demographic and clinical variables were recorded and HRQL was evaluated using a generic HRQL questionnaire (SF-36) for all subjects. For group 1, the severity of foot ulcers was assessed according to Wagner's classification, and disease-specific HRQL assessed using the Diabetes Foot Ulcer Scale (DFS).
  
  
  RESULTS
  HRQL was found to be significantly lower (P = 0.0001) in group 1 than in group 2 for all domains of the SF-36. Independent inverse relationships were found between good HRQL in the DFS domain of Leisure and Wagner grade (OR = 0.136 [0.029-0.467]) as well as the number of foot ulcers (OR = 0.365 [0.191-0.678]). Age was significantly associated with several DFS domains including Daily Activities, Physical Health and Dependence.
  
  
  CONCLUSIONS
  Our findings suggest that the number and severity of foot ulcers are associated with patient HRQL, especially in terms of leisure activity disruption and constraints due to treatment. These findings have implications for the evaluation, planning and management of patient care in diabetic foot disease.
authors.affiliation: Department of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, Paris-Nord University, Bondy, France. paul.valensi@jvr.ap-hop-paris.fr
authors.forename: P
authors.initials: P
authors.lastname: Valensi
authors.forename: I
authors.initials: I
authors.lastname: Girod
authors.forename: F
authors.initials: F
authors.lastname: Baron
authors.forename: T
authors.initials: T
authors.lastname: Moreau-Defarges
authors.forename: P
authors.initials: P
authors.lastname: Guillon
mesh_terms: D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000523:psychology; D003925:Diabetic Angiopathies / Q000503:physiopathology / Q000523:psychology; D017719:Diabetic Foot / Q000503:physiopathology* / Q000523:psychology*; D003929:Diabetic Neuropathies / Q000503:physiopathology / Q000523:psychology; D005260:Female; D016523:Foot Ulcer / Q000503:physiopathology / Q000523:psychology; D005602:France; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life