J Med Assoc Thai 2023; 106 (4):434-43

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Prevalence and Factors Associated with the Stratified Risk to Develop Diabetic Foot Ulcer in Type 2 Diabetes Mellitus Patients in Primary Care Unit of Songklanagarind Hospital
Limsomwong P , Wajanakomkul P Mail

Objective: To determine the prevalence of and to assess factors associated with diabetic foot in type 2 diabetes mellitus (DM) patients in the primary care unit (PCU) of Songklanagarind Hospital.

Materials and Methods: The present study was a cross-sectional study that collected the data of 160 type 2 DM patients attending the PCU of Songklanagarind Hospital between March and July 2020 using a questionnaire and face-to-face interviews. The classification of diabetic foot severity was based on foot examination using the 2017 Guideline of the Diabetes Association of Thailand.

Results: There were 160 participants in the present study, 44.4% were male and 55.6% were female. There were 58.1% aged less than 60 years and 41.9% aged more than or equal to 60 years. The diabetic patients who had foot ulcer were not found in the present study. There were 31.2%, 63.1%, and 5.6% of the patients had low, medium, and high risk of diabetic foot, respectively. In multivariate analysis, the adjusted odds ratios (ORs) with 95% confidence intervals (CI) found the factors associated with positively increased diabetic foot risk were some occupations including self-employed 5.19 (1.53 to 18.91) and agriculturist 4.82 (1.38 to 18.44), chronic kidney disease (CKD) 18.17 (2.46 to 131.32), longer duration of DM 3.14 (1.40 to 7.40), diabetic retinopathy (DR) 11.90 (3.44 to 50.00). Some factors negatively increased the risk were low-density lipoprotein (LDL) less than 100 mh/dL 0.37 (0.16 to 0.81), self-care behavior including asking others to check blind areas of the foot 0.21 (0.07 to 0.63), and foot exercise 0.29 (0.12 to 0.68) (p<0.05).

Conclusion: Diabetic foot in type 2 DM patients at the PCU of Songklanagarind Hospital was not found. However, it is important to establish PCU to identify feet at risk included occupations, CKD, longer duration of DM, LDL more than 100 mh/dL, DR, and lack of self-care practices for primary and secondary prevention in DM patients.

Keywords: Diabetes mellitus; Diabetic foot; Primary care

DOI: 10.35755/jmedassocthai.2023.04.13833

Received 10 October 2022 | Revised 15 February 2023 | Accepted 27 February 2023

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