title: Prevalence and risk factors for diabetes-related foot complications in Translating Research Into Action for Diabetes (TRIAD).
abstract: OBJECTIVE
  The objective was to describe the prevalence of diabetes-related foot complications in a managed care population and to identify the demographic and biological risk factors.
  
  
  METHODS
  We assessed the period prevalence of foot complications on 6992 patients using ICD-9 diagnosis codes from health plan administrative data. Demographic and biological variables were ascertained from surveys and medical record reviews. We defined four mutually exclusive groups: any Charcot foot, DFU with debridement, amputation±DFU and debridement, and no foot conditions.
  
  
  RESULTS
  Overall, 55 (0.8%) patients had Charcot foot, 205 (2.9%) had DFU with debridement, and 101 (1.4%) had a lower-extremity amputation. There were 6631 patients with no prevalent foot conditions. Racial/ethnic minorities were less likely to have Charcot foot (OR=0.21; 95% CI: 0.10, 0.46) or DFU (OR=0.61; 95% CI: 0.44, 0.84) compared to non-Hispanic Whites, but there were no racial/ethnic differences in amputation. Histories of micro- or macrovascular disease were associated with a two- to four-fold increase in the odds of foot complications.
  
  
  CONCLUSIONS
  In managed care patients with uniform access to health care, we found a relatively high prevalence of foot complications, but attenuation of the racial/ethnic differences of rates reported in the literature.
authors.affiliation: Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor, MI, USA. Electronic address: lmattei@med.umich.edu.
authors.forename: Laura N
authors.initials: LN
authors.lastname: McEwen
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Ylitalo
authors.forename: William H
authors.initials: WH
authors.lastname: Herman
authors.forename: James S
authors.initials: JS
authors.lastname: Wrobel
mesh_terms: D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000601:surgery; D017719:Diabetic Foot / Q000453:epidemiology* / Q000209:etiology* / Q000601:surgery; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D057170:Translational Research, Biomedical
keywords: Amputation; Charcot; Diabetes; Foot ulcer
references.citation: Diabet Med. 1997 Jan;14(1):46-9
references.pmid: 9017353
references.citation: Diabetes Care. 2003 May;26(5):1435-8
references.pmid: 12716801
references.citation: BMJ Open. 2013 Apr 08;3(4):
references.pmid: 23572197
references.citation: Medicine (Baltimore). 1972 May;51(3):191-210
references.pmid: 5021769
references.citation: J Chronic Dis. 1987;40(5):373-83
references.pmid: 3558716
references.citation: Diabetes Care. 2008 Jan;31(1):154-6
references.pmid: 17934155
references.citation: Diabetes Care. 1999 Jul;22(7):1036-42
references.pmid: 10388963
references.citation: J Diabetes. 2011 Sep;3(3):248-55
references.pmid: 21631901
references.citation: Am J Med. 2008 Nov;121(11):1008-14
references.pmid: 18954849
references.citation: Diabetes Care. 2000 Jun;23(6):796-800
references.pmid: 10840999
references.citation: Obesity (Silver Spring). 2012 Feb;20(2):460-2
references.pmid: 21996669
references.citation: Diabetes Care. 2004 May;27 Suppl 2:B39-44
references.pmid: 15113781
references.citation: Diabetes Care. 2009 May;32(5):816-21
references.pmid: 19196882
references.citation: JAMA. 2002 May 15;287(19):2519-27
references.pmid: 12020332
references.citation: Diabetes Care. 1998 Dec;21(12):2161-77
references.pmid: 9839111
references.citation: Diabetes Care. 2002 Feb;25(2):386-9
references.pmid: 11815515
references.citation: South Med J. 1998 Jul;91(7):643-8
references.pmid: 9671835
references.citation: Diabetes Care. 2008 Aug;31(8):1679-85
references.pmid: 18663232
references.citation: Phys Ther. 2008 Nov;88(11):1254-64
references.pmid: 18801858
references.citation: JAMA. 2005 Jan 12;293(2):217-28
references.pmid: 15644549
references.citation: Diabetes Care. 2003 Feb;26(2):495-501
references.pmid: 12547888
references.citation: Diabetes Care. 2010 Jan;33(1):98-100
references.pmid: 19825822
references.citation: Diabetes Care. 1990 May;13(5):513-21
references.pmid: 2351029
references.citation: Clin Podiatr Med Surg. 2008 Jan;25(1):17-28, v
references.pmid: 18165108
references.citation: Diabetes Metab Res Rev. 2011 May;27(4):402-9
references.pmid: 21360633
references.citation: J Foot Ankle Res. 2010 Nov 24;3:27
references.pmid: 21106076