History of and factors associated with diabetic foot ulcers in Norway: the Nord-Trøndelag Health Study.
OBJECTIVE
To determine the proportion of people with diabetes mellitus reporting a history of foot ulcer and to investigate factors associated with this adverse outcome.


METHODS
All inhabitants aged 20 years and older residing in a large geographic region were invited to participate in the Nord-Trøndelag Health Study, 71% (n=65,604) attended. Those reporting diabetes (n=1,972) were invited to take part in an ancillary study on diabetes. Based on 1,494 responses to the question: "Have you had a foot ulcer that required more than three weeks to heal'', the proportion with a history of foot ulcer was estimated.


RESULTS
The overall proportion with a history of foot ulcer was 10.4% (95% CI 8.8-11.9%). In the final multivariate logistic regression model, significant factors for a foot ulcer history included age > or =75 years (OR 1.8, 95% CI 1.2-2.8), height (men>175 cm, women>161 cm) (1.9, 95% CI 1.3-2.8), gender (male) (1.5, 95% CI 1.03-2.2), using insulin (1.6, 95% CI 1.1-2.4), and macrovascular complications (1.8, 95% CI 1.2-2.6).


CONCLUSIONS
The proportion of people reporting a history of foot ulcer in this population-based study exceeded the proportion of foot ulcer history reported previously. Height as a correlate has been occasionally reported in previous studies and needs further attention. Associated factors for a foot ulcer history help identify individuals who may be at particular risk of this adverse outcome.
Iversen
Marjolein M
MM
Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway. marjolein.iversen@hib.no
Midthjell
Kristian
K
Østbye
Truls
T
Tell
Grethe S
GS
Clipp
Elizabeth
E
Sloane
Richard
R
Nortvedt
Monica W
MW
Uhlving
Sverre
S
Hanestad
Berit R
BR
D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000188:drug therapy; D017719:Diabetic Foot / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires
D007004:Hypoglycemic Agents; D007328:Insulin