title: Foot ulceration in patients with diabetes: a risk analysis.
abstract: The study reported in this article aimed to analyse factors associated with the risk of ulceration in the feet of patients with diabetes using a conceptual hierarchic model. It was a cross-sectional study carried out with 1515 people with diabetes mellitus aged 40 years and older. The risk of foot ulceration was of higher significance in male patients with diabetes (adjusted odds ratio (OR)=1.39 (95% confidence interval (CI) 1.11 to 1.73); p=0.020), who did not practise a regular physical activity (adjusted OR=1.58 (95% CI 1.15 to 2.15); p=0.013), with time since diagnosis over 10 years (adjusted OR=1.42 (95% CI 1.10 to 1.86); p=0.011), who used insulin (adjusted OR=1.40 (95% CI 1.09 to 1.84); p=0.012), with retinopathy (adjusted OR=1.84 (95% CI 1.38 to 2.45); p=0.001) and who had had a previous stroke (adjusted OR=1.47 (95% CI 1.09 to 2.04); p=0.018). Mycosis on the nails and the interdigital spaces of the feet was statistically associated with ulceration risk independent of other variables of the model (adjusted OR=2.48 (95%CI 1.70 to 3.63); p=0.001). Finding the factors associated with ulceration contributes to the provision of quality care by nurses.
authors.affiliation: University Professor, Nursing Department, State University of Londrina, Londrina, Paraná, Brazil.
authors.forename: Mariana Angela
authors.initials: MA
authors.lastname: Rossaneis
authors.affiliation: University Professor Nursing Department, State University of Londrina, Londrina, Paraná, Brazil.
authors.forename: Maria do Carmo Fernandez Lourenço
authors.initials: MD
authors.lastname: Haddad
authors.affiliation: Nursing Department, Federal University of Paraná, Curitiba, Paraná, Brazil.
authors.forename: Maria de Fátima
authors.initials: MF
authors.lastname: Mantovani
authors.affiliation: Nursing Department, State University of Maringá, Maringá, Paraná, Brazil.
authors.forename: Sonia Silva
authors.initials: SS
authors.lastname: Marcon
authors.affiliation: PhD Student in Nursing, Nursing Graduate Program, State University of Maringá, Maringá, Paraná, Brazil.
authors.forename: Paloma de Souza Cavalcante
authors.initials: PS
authors.lastname: Pissinati
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003881:Dermatomycoses / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D017719:Diabetic Foot / Q000453:epidemiology* / Q000209:etiology; D003930:Diabetic Retinopathy / Q000453:epidemiology* / Q000209:etiology; D015444:Exercise; D005260:Female; D005533:Foot Dermatoses / Q000453:epidemiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D014009:Onychomycosis / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology*; D013997:Time Factors
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Diabetes complications; Diabetes mellitus; Diabetic foot; Nursing; Self-care