Incidence, prevalence, and potential risk factors for diabetic foot ulceration: A retrospective review at a multidisciplinary centre in Barbados
Objective Diabetes and lower extremity amputation rates in Barbados are among some of the highest globally, with peripheral neuropathy and peripheral vascular disease found to be independent risk factors for this population. Despite this, there is currently a lack of research evidence on rates of di...
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| Veröffentlicht in: | International wound journal 2023-04, Vol.20 (4), p.935-941 |
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| creator | Lovell, Laura Dunkley, Alison Webb, David Jarvis, Janet Gillies, Clare |
| description | Objective
Diabetes and lower extremity amputation rates in Barbados are among some of the highest globally, with peripheral neuropathy and peripheral vascular disease found to be independent risk factors for this population. Despite this, there is currently a lack of research evidence on rates of diabetic foot ulceration, which has amputation as its sequela. We aimed to evaluate the incidence and prevalence rates of active ulceration in a population of people with diabetes in Barbados. Secondly, we explored the risk factors for new/recurrent ulceration.
Research Design and Methods
Data were extracted from the electronic medical records for the period January 1, 2019 to December 31, 2020 for a retrospective cross‐sectional study for patients of a publicly‐funded diabetes management programme. Eligible records included people aged 18 years and above with a diagnosis of type 1 or 2 diabetes. Potential risk factors were explored using univariable logistic regression models.
Results
A total of 225 patients were included in the study (96% type 2 diabetes, 70.7% female, 98.7% Black Caribbean). The 1‐year period prevalence of diabetic foot ulceration was 14.7% (confidence interval [CI]: 10.5, 20.1). Incidence of ulceration in the same period was 4.4% (CI: 4.4, 4.5). Risk factors associated with diabetic foot ulceration included: retinopathy (OR 3.85, CI: 1.24, 11.93), chronic kidney disease (OR 9.86, CI: 1.31, 74.22), aspirin use (OR 3.326, CI: 1.02, 10.85), and clopidogrel use (OR 3.13, CI: 1.47, 6.68).
Conclusion
This study provided some insight into potential risk factors for foot ulceration in this population, which previous studies have shown to have higher rates of lower extremity amputations. Further research in this understudied group through a larger prospective cohort would allow more meaningful associations with risk factors and would be useful for the creation of risk prediction models. |
| doi_str_mv | 10.1111/iwj.13940 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10031241</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3090611229</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4440-18873b68d7d3de549f5118f547df98bf7a984462ff41d4e2ac3283bab0cc1b183</originalsourceid><addsrcrecordid>eNp1kd9qFDEUxgdRbLt64QtIwBsFt82_2cl4I7VUXSl4o-hdyCQnmjWbjElml76Fj2zs1EUFc5NzyI_vfCdf0zwi-JTUc-b2m1PCeo7vNMek43TJBfl891BjctSc5LzBmPZt291vjtgKC0YxOW5-rIN2BoKG52hMsFN-rlUwaIwFQnHKo-TyN2SVLjFlZGNCxqkBitO1iQVNXkNSxcXwAp2jBCXFPIIubge12znYI1WQQtvJF2dc1m70Lqh0jXQdkAC5gF6pNCgT84PmnlU-w8Pbe9F8fH354eLt8ur9m_XF-dVSc87xkgjRsWElTGeYgZb3tiVE2JZ3xvZisJ3qBecrai0nhgNVmlHBBjVgrclABFs0L2fdcRq2YG6MKC_H5LbVmIzKyb9fgvsqv8SdJBgzQjmpCk9vFVL8PkEucltXA-9VgDhlSTtCRYu7anTRPPkH3cQphbqfZLjHK0Io7Sv1bKZ0_b-cwB7cECx_BS1r0PIm6Mo-_tP-gfydbAXOZmDvPFz_X0muP72bJX8CSt-1Ww</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3090611229</pqid></control><display><type>article</type><title>Incidence, prevalence, and potential risk factors for diabetic foot ulceration: A retrospective review at a multidisciplinary centre in Barbados</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Access via Wiley Online Library</source><source>Wiley Online Library Open Access</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Lovell, Laura ; Dunkley, Alison ; Webb, David ; Jarvis, Janet ; Gillies, Clare</creator><creatorcontrib>Lovell, Laura ; Dunkley, Alison ; Webb, David ; Jarvis, Janet ; Gillies, Clare</creatorcontrib><description>Objective
Diabetes and lower extremity amputation rates in Barbados are among some of the highest globally, with peripheral neuropathy and peripheral vascular disease found to be independent risk factors for this population. Despite this, there is currently a lack of research evidence on rates of diabetic foot ulceration, which has amputation as its sequela. We aimed to evaluate the incidence and prevalence rates of active ulceration in a population of people with diabetes in Barbados. Secondly, we explored the risk factors for new/recurrent ulceration.
Research Design and Methods
Data were extracted from the electronic medical records for the period January 1, 2019 to December 31, 2020 for a retrospective cross‐sectional study for patients of a publicly‐funded diabetes management programme. Eligible records included people aged 18 years and above with a diagnosis of type 1 or 2 diabetes. Potential risk factors were explored using univariable logistic regression models.
Results
A total of 225 patients were included in the study (96% type 2 diabetes, 70.7% female, 98.7% Black Caribbean). The 1‐year period prevalence of diabetic foot ulceration was 14.7% (confidence interval [CI]: 10.5, 20.1). Incidence of ulceration in the same period was 4.4% (CI: 4.4, 4.5). Risk factors associated with diabetic foot ulceration included: retinopathy (OR 3.85, CI: 1.24, 11.93), chronic kidney disease (OR 9.86, CI: 1.31, 74.22), aspirin use (OR 3.326, CI: 1.02, 10.85), and clopidogrel use (OR 3.13, CI: 1.47, 6.68).
Conclusion
This study provided some insight into potential risk factors for foot ulceration in this population, which previous studies have shown to have higher rates of lower extremity amputations. Further research in this understudied group through a larger prospective cohort would allow more meaningful associations with risk factors and would be useful for the creation of risk prediction models.</description><identifier>ISSN: 1742-4801</identifier><identifier>EISSN: 1742-481X</identifier><identifier>DOI: 10.1111/iwj.13940</identifier><identifier>PMID: 36083201</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Afro‐Caribbean ; Age ; Amputation ; Aspirin ; Barbados ; Barbados - epidemiology ; Body mass index ; Comorbidity ; Cross-Sectional Studies ; Diabetes ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - epidemiology ; diabetic foot ; Diabetic Foot - complications ; Diabetic Foot - epidemiology ; Ethnicity ; Female ; Foot diseases ; Foot Ulcer - etiology ; Hemoglobin ; Humans ; Hypertension ; Incidence ; Ischemia ; Kidney diseases ; Leg ulcers ; Male ; Mortality ; Original ; Patients ; Peripheral neuropathy ; Population ; Prevalence ; Primary care ; Prospective Studies ; Retrospective Studies ; Risk Factors ; Smoking ; ulceration</subject><ispartof>International wound journal, 2023-04, Vol.20 (4), p.935-941</ispartof><rights>2022 The Authors. published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.</rights><rights>2022 The Authors. International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.</rights><rights>2023. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4440-18873b68d7d3de549f5118f547df98bf7a984462ff41d4e2ac3283bab0cc1b183</citedby><cites>FETCH-LOGICAL-c4440-18873b68d7d3de549f5118f547df98bf7a984462ff41d4e2ac3283bab0cc1b183</cites><orcidid>0000-0002-2640-6004 ; 0000-0001-8067-2525</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10031241/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10031241/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,1417,11562,27924,27925,45574,45575,46052,46476,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36083201$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lovell, Laura</creatorcontrib><creatorcontrib>Dunkley, Alison</creatorcontrib><creatorcontrib>Webb, David</creatorcontrib><creatorcontrib>Jarvis, Janet</creatorcontrib><creatorcontrib>Gillies, Clare</creatorcontrib><title>Incidence, prevalence, and potential risk factors for diabetic foot ulceration: A retrospective review at a multidisciplinary centre in Barbados</title><title>International wound journal</title><addtitle>Int Wound J</addtitle><description>Objective
Diabetes and lower extremity amputation rates in Barbados are among some of the highest globally, with peripheral neuropathy and peripheral vascular disease found to be independent risk factors for this population. Despite this, there is currently a lack of research evidence on rates of diabetic foot ulceration, which has amputation as its sequela. We aimed to evaluate the incidence and prevalence rates of active ulceration in a population of people with diabetes in Barbados. Secondly, we explored the risk factors for new/recurrent ulceration.
Research Design and Methods
Data were extracted from the electronic medical records for the period January 1, 2019 to December 31, 2020 for a retrospective cross‐sectional study for patients of a publicly‐funded diabetes management programme. Eligible records included people aged 18 years and above with a diagnosis of type 1 or 2 diabetes. Potential risk factors were explored using univariable logistic regression models.
Results
A total of 225 patients were included in the study (96% type 2 diabetes, 70.7% female, 98.7% Black Caribbean). The 1‐year period prevalence of diabetic foot ulceration was 14.7% (confidence interval [CI]: 10.5, 20.1). Incidence of ulceration in the same period was 4.4% (CI: 4.4, 4.5). Risk factors associated with diabetic foot ulceration included: retinopathy (OR 3.85, CI: 1.24, 11.93), chronic kidney disease (OR 9.86, CI: 1.31, 74.22), aspirin use (OR 3.326, CI: 1.02, 10.85), and clopidogrel use (OR 3.13, CI: 1.47, 6.68).
Conclusion
This study provided some insight into potential risk factors for foot ulceration in this population, which previous studies have shown to have higher rates of lower extremity amputations. Further research in this understudied group through a larger prospective cohort would allow more meaningful associations with risk factors and would be useful for the creation of risk prediction models.</description><subject>Afro‐Caribbean</subject><subject>Age</subject><subject>Amputation</subject><subject>Aspirin</subject><subject>Barbados</subject><subject>Barbados - epidemiology</subject><subject>Body mass index</subject><subject>Comorbidity</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>diabetic foot</subject><subject>Diabetic Foot - complications</subject><subject>Diabetic Foot - epidemiology</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Foot diseases</subject><subject>Foot Ulcer - etiology</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Incidence</subject><subject>Ischemia</subject><subject>Kidney diseases</subject><subject>Leg ulcers</subject><subject>Male</subject><subject>Mortality</subject><subject>Original</subject><subject>Patients</subject><subject>Peripheral neuropathy</subject><subject>Population</subject><subject>Prevalence</subject><subject>Primary care</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Smoking</subject><subject>ulceration</subject><issn>1742-4801</issn><issn>1742-481X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kd9qFDEUxgdRbLt64QtIwBsFt82_2cl4I7VUXSl4o-hdyCQnmjWbjElml76Fj2zs1EUFc5NzyI_vfCdf0zwi-JTUc-b2m1PCeo7vNMek43TJBfl891BjctSc5LzBmPZt291vjtgKC0YxOW5-rIN2BoKG52hMsFN-rlUwaIwFQnHKo-TyN2SVLjFlZGNCxqkBitO1iQVNXkNSxcXwAp2jBCXFPIIubge12znYI1WQQtvJF2dc1m70Lqh0jXQdkAC5gF6pNCgT84PmnlU-w8Pbe9F8fH354eLt8ur9m_XF-dVSc87xkgjRsWElTGeYgZb3tiVE2JZ3xvZisJ3qBecrai0nhgNVmlHBBjVgrclABFs0L2fdcRq2YG6MKC_H5LbVmIzKyb9fgvsqv8SdJBgzQjmpCk9vFVL8PkEucltXA-9VgDhlSTtCRYu7anTRPPkH3cQphbqfZLjHK0Io7Sv1bKZ0_b-cwB7cECx_BS1r0PIm6Mo-_tP-gfydbAXOZmDvPFz_X0muP72bJX8CSt-1Ww</recordid><startdate>202304</startdate><enddate>202304</enddate><creator>Lovell, Laura</creator><creator>Dunkley, Alison</creator><creator>Webb, David</creator><creator>Jarvis, Janet</creator><creator>Gillies, Clare</creator><general>Blackwell Publishing Ltd</general><general>John Wiley & Sons, Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2640-6004</orcidid><orcidid>https://orcid.org/0000-0001-8067-2525</orcidid></search><sort><creationdate>202304</creationdate><title>Incidence, prevalence, and potential risk factors for diabetic foot ulceration: A retrospective review at a multidisciplinary centre in Barbados</title><author>Lovell, Laura ; Dunkley, Alison ; Webb, David ; Jarvis, Janet ; Gillies, Clare</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4440-18873b68d7d3de549f5118f547df98bf7a984462ff41d4e2ac3283bab0cc1b183</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Afro‐Caribbean</topic><topic>Age</topic><topic>Amputation</topic><topic>Aspirin</topic><topic>Barbados</topic><topic>Barbados - epidemiology</topic><topic>Body mass index</topic><topic>Comorbidity</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>diabetic foot</topic><topic>Diabetic Foot - complications</topic><topic>Diabetic Foot - epidemiology</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Foot diseases</topic><topic>Foot Ulcer - etiology</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Incidence</topic><topic>Ischemia</topic><topic>Kidney diseases</topic><topic>Leg ulcers</topic><topic>Male</topic><topic>Mortality</topic><topic>Original</topic><topic>Patients</topic><topic>Peripheral neuropathy</topic><topic>Population</topic><topic>Prevalence</topic><topic>Primary care</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Smoking</topic><topic>ulceration</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lovell, Laura</creatorcontrib><creatorcontrib>Dunkley, Alison</creatorcontrib><creatorcontrib>Webb, David</creatorcontrib><creatorcontrib>Jarvis, Janet</creatorcontrib><creatorcontrib>Gillies, Clare</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library (Open Access Collection)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International wound journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lovell, Laura</au><au>Dunkley, Alison</au><au>Webb, David</au><au>Jarvis, Janet</au><au>Gillies, Clare</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence, prevalence, and potential risk factors for diabetic foot ulceration: A retrospective review at a multidisciplinary centre in Barbados</atitle><jtitle>International wound journal</jtitle><addtitle>Int Wound J</addtitle><date>2023-04</date><risdate>2023</risdate><volume>20</volume><issue>4</issue><spage>935</spage><epage>941</epage><pages>935-941</pages><issn>1742-4801</issn><eissn>1742-481X</eissn><abstract>Objective
Diabetes and lower extremity amputation rates in Barbados are among some of the highest globally, with peripheral neuropathy and peripheral vascular disease found to be independent risk factors for this population. Despite this, there is currently a lack of research evidence on rates of diabetic foot ulceration, which has amputation as its sequela. We aimed to evaluate the incidence and prevalence rates of active ulceration in a population of people with diabetes in Barbados. Secondly, we explored the risk factors for new/recurrent ulceration.
Research Design and Methods
Data were extracted from the electronic medical records for the period January 1, 2019 to December 31, 2020 for a retrospective cross‐sectional study for patients of a publicly‐funded diabetes management programme. Eligible records included people aged 18 years and above with a diagnosis of type 1 or 2 diabetes. Potential risk factors were explored using univariable logistic regression models.
Results
A total of 225 patients were included in the study (96% type 2 diabetes, 70.7% female, 98.7% Black Caribbean). The 1‐year period prevalence of diabetic foot ulceration was 14.7% (confidence interval [CI]: 10.5, 20.1). Incidence of ulceration in the same period was 4.4% (CI: 4.4, 4.5). Risk factors associated with diabetic foot ulceration included: retinopathy (OR 3.85, CI: 1.24, 11.93), chronic kidney disease (OR 9.86, CI: 1.31, 74.22), aspirin use (OR 3.326, CI: 1.02, 10.85), and clopidogrel use (OR 3.13, CI: 1.47, 6.68).
Conclusion
This study provided some insight into potential risk factors for foot ulceration in this population, which previous studies have shown to have higher rates of lower extremity amputations. Further research in this understudied group through a larger prospective cohort would allow more meaningful associations with risk factors and would be useful for the creation of risk prediction models.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>36083201</pmid><doi>10.1111/iwj.13940</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-2640-6004</orcidid><orcidid>https://orcid.org/0000-0001-8067-2525</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Access via Wiley Online Library; Wiley Online Library Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Afro‐Caribbean Age Amputation Aspirin Barbados Barbados - epidemiology Body mass index Comorbidity Cross-Sectional Studies Diabetes Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - epidemiology diabetic foot Diabetic Foot - complications Diabetic Foot - epidemiology Ethnicity Female Foot diseases Foot Ulcer - etiology Hemoglobin Humans Hypertension Incidence Ischemia Kidney diseases Leg ulcers Male Mortality Original Patients Peripheral neuropathy Population Prevalence Primary care Prospective Studies Retrospective Studies Risk Factors Smoking ulceration |
| title | Incidence, prevalence, and potential risk factors for diabetic foot ulceration: A retrospective review at a multidisciplinary centre in Barbados |
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