Abbott CA, Garrow AP, Carrington AL, Morris J, Van Ross ER, Boulton AJ, North-West diabetes foot care study., et al.
Diabetes care. Date of publication 2005 Aug 1;volume 28(8):1869-75.
1. Diabetes Care. 2005 Aug;28(8):1869-75.
Foot ulcer risk is lower in South-Asian and african-Caribbean compared with
European diabetic patients in the U.K.: the North-West diabetes foot care study.
Abbott CA(1), Garrow AP, Carrington AL, Morris J, Van Ross ER, Boulton AJ;
North-West diabetes foot care study.
Author information:
(1)Department of Medicine, Manchester Royal Infirmary, University of Manchester,
Manchester, UK. ca.abbott@btinternet.com
OBJECTIVE: To determine 1) foot ulcer rates for European, South-Asian, and
African-Caribbean diabetic patients in the U.K and 2) the contribution of
neuropathy and peripheral arterial disease (PAD) differences to altered ulcer
risk between the groups.
RESEARCH DESIGN AND METHODS: In this U.K. population-based study, we screened
15,692 type 1 and type 2 diabetic patients in the community health care setting
for foot ulcers, foot deformities, neuropathy, and PAD plus other
characteristics. In total, 13,409 were European (85.5%), 1,866 were South Asian
(11.9%), and 371 were African Caribbean (2.4%).
RESULTS: The age-adjusted prevalence of diabetic foot ulcers (past or present)
for Europeans, South Asians, and African Caribbeans was 5.5, 1.8, and 2.7%,
respectively (P < 0.0001). Asians and African Caribbeans had less neuropathy,
PAD, and foot deformities than Europeans (P = 0.003). The unadjusted risk of
ulcer (odds ratio [OR]) for Asians versus Europeans was 0.29 (95% CI 0.20-0.41)
(P < 0.0001). PAD, neuropathy, foot deformities, and insulin use attenuated the
age-adjusted OR from 0.32 to 0.52 (0.35-0.76) (P < 0.0001). African-Caribbean
versus European ulcer risk in males was attenuated from 0.60 to 0.71 by vibration
sensation.
CONCLUSIONS: South Asians with diabetes in the U.K. have about one-third the risk
of foot ulcers of Europeans. The lower levels of PAD, neuropathy, insulin usage,
and foot deformities of the Asians account for approximately half of this reduced
foot ulcer risk. Lower neuropathy is the main contributor to the reduced
African-Caribbean ulcer rate, particularly in men. The reasons for these ethnic
differences warrant further investigation.
PMID: 16043725 [Indexed for MEDLINE]
