[A multicenter survey on the diabetic foot and its neuropathy in China].
OBJECTIVE
To investigate the characteristics of diabetic foot with neuropathy and its related factors.


METHODS
530 out- and in-patients in 14 grade A class 3 comprehensive hospitals in China with foot problems were surveyed. 337 of the 500 patients (63.58%) suffered from neuropathy, 172 (32.45%) with diabetic foot with simple neuropathy and 165 (31.13%) with simple neuropathy combined with peripheral artery disease (PAD). 193 of the 500 patients (36.42%) suffered from peripheral artery disease (PAD). 77.7% of ulcer were caused by physical factors. Questionnaire survey was conducted to collect the demographic data, present and past history, history of the hyperglycemia and lipid disorders, classification and phases of the foot ulcers based on Wagner' system and Texas system, characteristics of neuropathy and other diabetic complications, and relative risk factors. Detailed physical examination was performed, including 10 g nylon filament sensation examination.


RESULTS
The duration of diabetic foot of the patients with simple neuropathy was 3 (1, 60) months, significantly shorter than that of the diabetic foot patients with PAD [5 (1, 96) months, P < 0.001]. The Wagner degree of ulcer was related to the duration of diabetes, economic income, foot deformity, nerve reflection, diapason vibration sensation of foot, sensation point of 10 g nylon filament, ankle/brachial index (ABI), foot artery pulse, fasting blood sugar (FBS) and glycated hemoglobin (HbA1c). Stepwise regression analysis revealed that ABI of left posterior tibial artery, vibration detection threshold and economic income were the most significant influencing factors of the degree of ulcer.


CONCLUSIONS
Neuropathy ulcer is common in diabetic foot patients. The prognosis of healing in diabetic foot with neuropathy is prior to that of diabetic foot with PAD. The neuropathy and PAD of foot influence each other and aggravate the condition of diabetic foot. The examinations of diapason vibration sensation of foot, sensation point of 10 g nylon filament, and Achilles tendon reflex are simple and practical, and are worth recommending.
First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China. linshaoda@126.com
Shao-da
SD
Lin
Chu-jia
CJ
Lin
Ai-hong
AH
Wang
Shi
S
Zhao
Li
L
Yan
Peng-hua
PH
Wang
Yu-ming
YM
DU
Zhan-jian
ZJ
Wang
Zheng-hua
ZH
Xiao
Xue-yi
XY
Ma
Guo-chang
GC
Chen
Ying-sheng
YS
Zhou
Qiang
Q
Li
Rong-wen
RW
Bian
Ji-Ping
JP
Mao
Zhang-rong
ZR
Xu
D000368:Aged; D002681:China / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000453:epidemiology; D017719:Diabetic Foot / Q000175:diagnosis / Q000453:epidemiology*; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D011795:Surveys and Questionnaires