A study on the prevalence of risk factors and presence of diabetic foot ulcers in T2DM patients in K. R. Hospital, Mysuru

Chandrashekar S., Suraj Muralidhar


Background: India is one of the top ten diabetes mellitus (DM) countries. Thus, the aim of this study was to survey the prevalence of DFU risk factors and DFU prevalence among type 2 diabetes mellitus (T2DM) patients.

Methods: An epidemiological study was conducted on an outpatient basis in K. R. hospital, Mysuru. All T2DM participants were ≥ 18 years were included. Demographic and foot care behavior were assessed using minimum data sheet (MDS). Meanwhile, presence of risk factors was evaluated for neuropathy and presence of angiopathy was evaluated with ankle brachial index (ABI) by using a hand-held doppler both dorsal and posterior tibial.

Results: At the end of study, 249 T2DM participants were enrolled. The prevalence of DFU risk factors was 55.4% (95% CI: 53.7% - 57.0%), and prevalence of DFU was 12% (95% CI: 10.3% - 13.6%).

Conclusions: Even though the prevalence of DFU is high, identification associated factors for presence of risk and DFU has not been integrated into national guideline. Thus, preventive strategies should be introduced at early stage to prevent presence of risk and DFU.



Diabetic foot, Risk factor, Ulcer

Full Text:



Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Practice. 2010;87:4-14.

Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Practice. 2014;103:137-49.

Waspadji S, Ranakusuma A, Suyono S, Supartondo, S, Sukaton U. Diabetes mellitus in an urban population. Tohoku J Experimental Med. 1983;141:219-28.

Mihardja L, Manz HS, Ghani L, Soegondo S. Prevalence and determinants of diabetes mellitus and impaired glucose tolerance in Indonesia (a part of basic health research/Riskesdas). Acta Medica Indonesiana. 2009;41(4):169-74.

Soewondo P, Ferrario A, Tahapary DL. Challenges in diabetes management in india: a literature review. Global Health. 2013;9:1-17.

International Working Group on the Diabetic Foot (IWGDF) (2013) Pathophysiology of Foot Ulceration. Available at

Fernando M, Crowther R, Lazzarini P, Sangla K, Cunningham M, Buttner P, Golledge J. Biomechanical characteristics of peripheral diabetic neuropathy: a systematic review and meta-analysis of findings from the gait cycle, muscle activity and dynamic barefoot plantar pressure. Clin Biomechanics. 2013;28(8):831-45.

Huijberts MS, Schaper NC, Schalkwijk CG. Advanced glycation end products and diabetic foot disease. Diabetes Metabolism Res Reviews. 2008;24:19-24.

Malgrange D, Richard JL, Leymarie F. French Working group on the diabetic foot. screening diabetic patients at risk for foot ulceration, a multi-centre hospital-based study in France. Diabetes Metabolism. 2003;29(3):261-8.

Reiber GE, Vileikyte LO, Boyko ED, Del Aguila M, Smith DG, Lavery LA, et al. Causal pathways for incident lower-extremity ulcers in patients with diabetes from two settings. Diabetes care. 1999;22(1):157-62.

Vandenbroucke JP, Von Elm E, Altman DG, Gotzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the reporting of observational studies in epidemiology (STROBE). Explanation and elaboration. Epidemiol. 2007;18:805-35.

Sutanegara D, Budhiarta DA. The epidemiology and management of diabetes mellitus in India. Diabetes Res Clin Practice. 2000;50:S9-16.

Adam FMS, Adam JMF, Pandeleki N, Mappangara, I. Asymptomatic diabetes: the difference be- tween population-based and office-based screening. Acta Medica. 2000;38:67-71.

Hu L, Bao X, Zhou S, Guan X, Xin HL. Estimation of sample size and testing power (Part 1). J Integrative Med. 2011;9:1070-4.

Boulton AJ, Armstrong DG, Albert SF, Frykberg RG, Hellman R, Kirkman MS, et al. Comprehensive foot examination and risk assessment. Diabetes care. 2008;31(8):1679-85.

American Diabetes Association (ADA) (2013) Executive Summary: Standards of Medical Care in Diabetes 2013. Diabetes Care. Available at http://care.diabetesjournals. org/content/36/Supplement_1/S4.