| BackgroundRencently, the number of people with diabetes is gradually climbing with the social development and longer life expectancy. Diabetes is one of the foremost causes of death in many countries and a leading cause of blindness, renal failure, and nontraumatic amputation. The IDF has reported that global prevalence of diabetes in 2003 was estimated to be 194 millions ,and by 2030, this figure is predicted to rise to 366 millions. Thus,the acute and chronic complications are rising. The figure from International Working Group on the Diabetic Foot reveals that 15% of people with diabetes will experience a foot ulcer at some point in their lifetime, although recent research suggests the figure may be as high as 25%, and 15-20% of people with diabetes in the US will be hospitalized with a foot complication at some point during the course of their disease. Ulcers of the diabetic foot are associated with amputation in 14% to 24%, and death in 5% to 13% of cases. After an amputation there is a 25% incidence of contralateral amputations within 3 years.According to statistics,the number of diabetes in China is 50 millions, and annual expenditures for diabetes management was 1700 billions RMB. 20% people with diabetes have diabetic foot,and 40% of them need amputation. While,there is a 10% incidence of death after amputation in 30 days, and 50% incidence of death within 5 years. Diabetic foot has a dramatic effect on the patients and the society. The management of diabetic foot is hard , but the diagnose is relatively easy .The prevention is effective,The incidence of amputation decreased to 50% with efficient prevention in Europe and the U.S.The prevention depends on the discovering and correcting the high risk of diabetic foot as soon as possible.ObjectivesA case-control study enrolling patients with diabetic foot and patients with diabetes discusses the clinical feature of diabetic foot by clinical examinations and labouratory tests. And the study intends to expound the high risks of diabetic foot as to infoming and educating the patients with diabetes as soon as possible.MethodsA case-control study was used. 59 patients with diabetic foot and 53 patients with Type 2 diabees were enrolled in our study. We adopted and detected the following items:sex, age, smoking,duration of diabetes, Swelling of the foot or ankle ,Deformity or bony prominences, Corns or calluses, repetitive trauma,BMI, HbA1C,serum total cholesterol, triglyceride, HDL, LDL, apolipoproteinA1, apolipoproteinB, FIB, ultrasound of vascular, ABI, radiography of the stomach and intestine, ultrasound of cholecyst, MAU, VMA, HSCRP,P-NE, U-NE, sensation threshold of vibration, variety heart rate per minute in deep breathing, fluctuation of blood pressure when standing up .Results1. With the software of SPSS 16,Measurement data adopt t test:1.1 Patients with diabetic foot and patients with diabetes have significant differences about age ,and the patients with diabetic foot are older.(t=-3.419,P<0.01)1.2 Patients with diabetic foot and patients with diabetes have no significant differences about duration of diabetes in our test. (t=-1.936,P>0.05)1.3 Patients with diabetic foot and patients with diabetes have no significant differences on HbA1c in our test. (t=1.745,P>0.05)1.4 Patients with diabetic foot and patients with diabetes have no significant differences on BMI in our test. (t=1.918,P>0.05)1.5 Patients with diabetic foot and patients with diabetes have no significant differences on triglyceride in our test. (t=1.723,P>0.05)1.6 Patients with diabetic foot and patients with diabetes have significant differences about serum total cholesterol ,and the test value of patients with diabetes are higher.(t=3.735,P<0.01)1.7 Patients with diabetic foot and patients with diabetes have no significant differences on HDL in our test. (t=0.862,P>0.05)1.8 Patients with diabetic foot and patients with diabetes have significant differences on LDL ,and the test value of patients with diabetes are higher.(t=4.136,P<0.01)1.9 Patients with diabetic foot and patients with diabetes have significant differences on apolipoproteinA1, ,and the test value of patients with diabetes are higher.(t=2.14,P<0.05)1.10 Patients with diabetic foot and patients with diabetes have significant differences on apolipoproteinB, ,and the test value of patients with diabetes are higher.(t=2.764,P<0.01)1.11 Patients with diabetic foot and patients with diabetes have significant differences on FIB, ,and the test value of patients with diabetic foot are higher.(t=--2.373,P<0.05)1.12 Patients with diabetic foot and patients with diabetes have significant differences on ABI, ,and the test value of patients with diabetes are higher.(left:t=3.923,P<0.01,right:t=1.987,P<0.05)1.13 Patients with diabetic foot and patients with diabetes have significant differences on HSCRP, ,and the test value of patients with diabetic foot are higher.(t=--5.006,P<0.01)1.14 Patients with diabetic foot and patients with diabetes have significant differences on VMA, ,and the test value of patients with diabetic foot are higher.(t=--4.595,P<0.01)1.15 Patients with diabetic foot and patients with diabetes have significant differences on P-NE, ,and the test value of patients with diabetic foot are higher.(t=-6.868,P<0.01) 1.16 Patients with diabetic foot and patients with diabetes have significant differences on U-NE, ,and the test value of patients with diabetic foot are higher.(t=-2.807,P<0.01)1.17 Patients with diabetic foot and patients with diabetes have significant differences on fluctuation of blood pressure when standing up ,and the test value of patients with diabetic foot are higher.(t=-7.1,P<0.05)1.18 Patients with diabetic foot and patients with diabetes have no significant differences on variety heart rate per minute in deep breathing in our test. (t=-0.834,P>0.05)2. With the software of SPSS 16,Count data adopt Chi-square test:2.1 Patients with diabetic foot and patients with diabetes have no significant differences on sex in our test. (X2=0.250,P=0.617)2.2 Patients with diabetic foot and patients with diabetes have no significant differences on smoking in our test. (X2=2.686,P=0.101)2.3 Patients with diabetic foot and patients with diabetes have significant differences on Swelling of the foot or ankle(X2=8.772,P<0.05, OR=3.449),And we can get the conclution that Swelling of the foot or ankle is the high risk of diabetic foot.2.4 Patients with diabetic foot and patients with diabetes have significant differences on Deformity of the foot(X2=40.811,P<0.01, OR=39.913),And we can get the conclution that Deformity of the foot is the high risk of diabetic foot.2.5 Patients with diabetic foot and patients with diabetes have significant differences on calluses of the foot(X2=11.315,P<0.01, OR=7.317),And we can get the conclution that calluses of the foot is the high risk of diabetic foot.2.6 Patients with diabetic foot and patients with diabetes have significant differences on repetitive trauma of the foot(X2=57.829,P<0.01, OR=74.8),And we can get the conclution that repetitive trauma of the foot is the high risk of diabetic foot. 2.7 Patients with diabetic foot and patients with diabetes have significant differences on ultrasound of vascular(X2=38.693,P<0.01, OR=15.077),And we can get the conclution that peripheral artery disease is the high risk of diabetic foot.2.8 Patients with diabetic foot and patients with diabetes have significant differences on MAU(X2=12.725,P<0.01, OR=4.276),And we can get the conclution that Chronic renal damage is the high risk of diabetic foot.2.9 Patients with diabetic foot and patients with diabetes have significant differences on ultrasound of cholecyst(X2=17.159,P<0.01, OR=5.568),And we can get the conclution that ultrasound of cholecyst can reflex the risk of diabetic foot.2.10 Patients with diabetic foot and patients with diabetes have significant differences on radiography of the stomach and intestine(X2=14.485,P<0.01, OR=4.846),And we can get the conclution that radiography of the stomach and intestine can reflex the risk of diabetic foot.2.11 Patients with diabetic foot and patients with diabetes have significant differences on the sensation threshold of vibration(left:X2=17.959,P<0.05, right: X2=13.431,P<0.01).Conclusions1. older age and chronic renal disease are the relative factors of high incidence of diabetic foot.2. Swelling of the foot or ankle ,Deformity or bony prominences, Corns or calluses, and repetitive trauma are all the high risks of diabetic foot.3. By ABI and ultrasound of vascular ,we can estimate the state of the Lower extremity vascular definitely.4. The high level of FIB can lead to hypercoagulable state.And this can Accelerate the diabetic foot.5. Radiography of the stomach and intestine, and ultrasound of cholecyst can reflex the function of digestive system.We can infer the state of the autonomic nerve indirectly by the function of the stomach and intestine. 6. The item of VMA,P-NE, U-NE and fluctuation of blood pressure can be regarded as the significant index of estimating the autonomic dysfunction of the patient with diabetic foot7. The sensation threshold of vibration can reflex the damage state of Sensory nerve objectively.8. The level of HSCRP are observably high in the patients with diabetic foot,this imply the high Inflammation in the patients with diabetic foot,this need Investigate further.
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