title: Charcot osteoarthropathy in type 2 diabetes persons presenting to specialist diabetes clinic at a tertiary care hospital.
abstract: BACKGROUND
  Charcot osteoarthropathy or charcot foot is a rare, chronic, non-communicable condition of bones and joints which may results into severe deformity and more prone to develop ulcers possibly leading to amputation. The purpose of this study was to determine the prevalence of Charcot osteoarthropathy and its association with age, BMI, gender, duration of diabetes, HBA1c and peripheral neuropathy.
  
  
  METHODS
  A total of 1931 subjects with type 2 diabetes having mean age 50.72 ± 10.66 years presenting in a specialist diabetes clinic at shalamar hospital, Lahore, Pakistan were enrolled. The diagnosis of Charcot osteoarthropathy was made by examination of both dorsal and plantar surfaces of foot for swelling, erythema, increase in temperature and any musculoskeletal deformity which was later confirmed by radiographs. Assessment of neuropathy was carried out by checking the sense of pressure, joint position and vibration. BMI (Body Mass Index), fasting blood glucose (FBG) and HbA1C were determined.
  
  
  RESULTS
  In all subjects including male 704 (36.45 %) and female 1227 (63.55 %), 0.4 % subjects had charcot deformity, while 0.2 %, 0.15 % and 0.05 % subjects having right, left and bilateral deformity respectively. Bilaterally symmetrical neuropathy was diagnosed in 25.4 % in subjects. There was a significant association (p < 0.05) of deformity with duration of diabetes, HbA1C and neuropathy, however no significant association (p > 0.05) was found with age, BMI, weight, height and gender.
  
  
  CONCLUSIONS
  There is a need to have a special care of persons with diabetes regarding blood glucose control and development of peripheral neuropathy. Early identification and management of risk factors may prevent the occurrence of charcot deformity. Patients must be educated about the foot care.
authors.affiliation: Department of Endocrinology Medicine, Shalamar Medical and Dental College Lahore, Shalamar Link Road Lahore, Postal address: 2-J Gulberg III, Lahore, Pakistan. bilalbin@gmail.com.
authors.forename: Bilal Bin
authors.initials: BB
authors.lastname: Younis
authors.affiliation: Department of Physiology, Shalamar Medical and Dental College, Lahore, Pakistan. dradeelas@hotmail.com.|Department of Physiology and Cell Biology, University of Health Sciences, Lahore, Pakistan. dradeelas@hotmail.com.
authors.forename: Adeela
authors.initials: A
authors.lastname: Shahid
authors.affiliation: Department of Endocrinology Medicine, Shalamar Medical and Dental College Lahore, Shalamar Link Road Lahore, Postal address: 2-J Gulberg III, Lahore, Pakistan. rozina979@gmail.com.
authors.forename: Rozina
authors.initials: R
authors.lastname: Arshad
authors.affiliation: Department of Endocrinology Medicine, Shalamar Medical and Dental College Lahore, Shalamar Link Road Lahore, Postal address: 2-J Gulberg III, Lahore, Pakistan. dr.cyma@yahoo.com.
authors.forename: Saima
authors.initials: S
authors.lastname: Khurshid
authors.affiliation: Department of Endocrinology Medicine, Shalamar Medical and Dental College Lahore, Shalamar Link Road Lahore, Postal address: 2-J Gulberg III, Lahore, Pakistan. Dph_junaidmasood@hotmail.com.
authors.forename: Junaid
authors.initials: J
authors.lastname: Masood
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001177:Arthropathy, Neurogenic / Q000453:epidemiology* / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000378:metabolism; D017719:Diabetic Foot / Q000453:epidemiology* / Q000378:metabolism; D003929:Diabetic Neuropathies / Q000453:epidemiology / Q000378:metabolism; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010154:Pakistan / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D062606:Tertiary Care Centers; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human