title: Diabetic foot complications among patients attending a specialist diabetes clinic in Jamaica: prevalence and associated factors.
abstract: OBJECTIVE
  To estimate the prevalence of diabetic foot complications among patients at a specialist diabetes clinic in Jamaica and identify factors associated with foot complications.
  
  
  METHODS
  A stratified random sample of 188 patients were interviewed and examined between 2009 and 2010. Trained nurses obtained demographic and clinical data, measured anthropometrics and performedfoot examinations including inspection for amputations, ulcers or infection and assessment of pain, vibration and pressure perception.
  
  
  RESULTS
  Participants included 143 women and 45 men (mean age 56years; mean diabetes duration 16 years). The prevalence of amputations was 8.5% (95% CI 4.5, 12.5%) and was higher among men (22.2%) compared to women (4.2%, p < 0.05). Prevalence of current ulcers and current foot infections was 4.3% and 3.7%, respectively. Overall, 12% ofpatients had at least one of these foot complications. Foot complications were more prevalent among men, patients with high blood pressure (BP > or = 130/80 mmHg) or peripheral neuropathy In multivariable logistic regression models, factors associated with foot complications were: neuropathy (OR 9.3 [95% CI 2.8, 30.3]), high BP (OR 7.9 [1.3, 49.7]) and diabetes duration (OR 1.32 [1.02, 1.72]).
  
  
  CONCLUSIONS
  Approximately one of every eight patients in this specialist clinic had a major foot complication. Associated factors were neuropathy, high blood pressure and longer duration of diabetes.
authors.affiliation: Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Jamaica, West Indies. trevor.ferguson02@uwimona.edu.jm
authors.forename: T S
authors.initials: TS
authors.lastname: Ferguson
authors.affiliation: Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors.forename: M K
authors.initials: MK
authors.lastname: Tulloch-Reid
authors.affiliation: Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors.forename: N O M
authors.initials: NO
authors.lastname: Younger
authors.affiliation: Department of Medicine, The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors.forename: R A
authors.initials: RA
authors.lastname: Wright-Pascoe
authors.affiliation: Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors.forename: M S
authors.initials: MS
authors.lastname: Boyne
authors.affiliation: Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors.forename: S R
authors.initials: SR
authors.lastname: McFarlane
authors.affiliation: Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors.forename: D K
authors.initials: DK
authors.lastname: Francis
authors.affiliation: Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors.forename: R J
authors.initials: RJ
authors.lastname: Wilks
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D017719:Diabetic Foot / Q000453:epidemiology*; D003929:Diabetic Neuropathies / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007563:Jamaica / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016491:Peripheral Vascular Diseases / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D013997:Time Factors