Prevalence And Influencing Factors Of Foot High Risk Factor Screening In Diabetic Patients In Guangdong Province

Objective(1)To investigate the present situation of high risk factors of foot in diabetic patients in Guangdong Province;(2)To analyze the risk factors of diabetic feet,and to provide evidence for making intervention program.Methods(1)A cluster sampling method was used to sample 15 medical institutions and some of subordinate community health service centers from Pearl River Delta,eastern Guangdong,western Guangdong and northern Guangdong;(2)From April to December 2018,the patients who with diabetes were be investigated,the screening tools be recommended by the International Working Group on the Diabetic Foot(IWGDF),the screening tools including the basic information registration form,the diabetic foot assessment form,the foot care knowledge questionnaire,and the diabetic foot risk classification system;(3)SPSS22.0 software package was used to analyze data by descriptive statistics,t-test,chi-square test and Logistic regression analysis.Results(1)A total of 970 patients with type 2 diabetic were screened,12 patients with incomplete data were excluded,958 patients(98.8%)had valid data.There were 449 males(46.8%)and 509females(53.2%);the mean age was(62.87±11.45)years;the mean diabetic duration was(7.00±6.40)years.There were 352(36.7%)patients in the Pearl River Delta,160(16.7%)patients in northern Guangdong,292(30.5%)patients in eastern Guangdong,and 154(16.1%)patients in western Guangdong;(2)Risk factors and grading of diabetic foot: Risk factors and classification of diabetic foot: 345 cases(36.0%),252 cases(26.3%),289 cases(30.2%),72 cases(7.5%)of patients with diabetic feet risk level 0,1,2 and 3 respectively;High risk factors of feet: The percentage of patients with dry / chapped skin,abnormal pulse of posterior tibial artery,callus,deformity and numbness ranged from 28.2% to 40.6%.The percentage of patients withabnormal foot temperature sense,pressure sense,vibration sense,acupuncture sense and skin temperature ranged from 15.3% to 18.8%,The percentage of patients with history of foot ulcer and abnormal ankle reflex were 7.5% and 5.9% respectively;(3)The total score of foot care knowledge of the patients was(14.08 ± 3.22)point,the highest dimension score for the shoe type selection was(3.47 ± 1.05)point,the lowest dimensional score for the treatment of foot problems was(2.22 ± 0.85)point;(4)The blood glucose and blood lipids of the patients who with high-risk foot exceeded the guideline control targets(Chinese guidelines for prevention and treatment of Type 2diabetic,2017 Edition).The mean values of fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin,cholesterol,and triglycerides in high-risk foot patients were2.31 mmol/L?3.29 mmol/L?1.41 %?0.62 mmol/Land0.26 mmol/Lhigher respectively than the control target;(5)Multivariate regression analysis showed that there were independent risk factors for diabeteic patients with high-risk foot.including in age(OR =1.33,95%CI:1.099?1.793,P=0.041),diabetic duration(OR=1.161,95%CI:1.024?3.593,P=0.035),diabetic retinopathy(OR=1.797,95%CI:1.121?2.881,P=0.015),dry / chapped skin(OR=1.815,95%CI:1.353?2.434,P<0.001)and callus(OR=1.557,95%CI:1.062?2.662,P=0.031).Conclusion(1)The highest proportion of diabetic patients with a certain feet high risk factor was 40.6% in 15 medical institutions and some of subordinate community,dry skin/ cleft palate,sputum,deformity,numbness,abnormal posterior tibial artery pulsation,abnormal temperature sensation,abnormal pressure sensation,abnormal vibration sensation and abnormal acupuncture analgesia were common in diabetic patients;(2)Diabetic patients were lack of foot care knowledge;(3)Metabolic control of high-risk diabetic foot patients was not ideal;(4)Age,diabetic course,diabetic retinopathy,dry skin/ cleft and callosities were independent risk factors for diabetic patients with high-risk foot.