Risk assessment of patients with diabetes for foot ulcers according to risk classification consensus of international working group on diabetic foot (IWGDF)

Objective: The aim was assessment of diabetic foot ulcer risk factors according to International Working Group on the Diabetic Foot (IWGDF) consensus.

Methodology: All referred patients with diabetes were divided into four groups based on IWGDF criteria (without neuropathy, with neuropathy, neuropathy with deformity or vascular disorders, foot ulcer or amputation history).

Results: Mean age of patients was 53.8±10.7 years. Two hundred and sixty nine patients ​(62/6%) were female and 161(37/4%) were male. Twenty three percent had disturbed sense of vibration, 26% had decreased sensitivity to monofilaments and 17% had decreased pain sensation. Ankle brachial index (ABI) was abnormal in 6%. About 7% had history of prior ulcer. Patients were classified into four risk groups according to IWGDF criteria. Two hundred and seventy seven patients (65%) were in group 0, 75(17%) in group 1, 47 (11%) in group 2 and 31 (7%) in group 3. Patients in higher–risk groups had higher age, longer diabetes duration, higher HbA1C and less training (p=0.0001, 0.001, 0.0001, 0.021 respectively). The risk was higher in the presence of retinopathy (p=0.005). Patient’s sex, BMI, smoking and nephropathy did not have significant correlation with risk of diabetic foot ulcer.

Conclusion: This study showed that increase of age, duration of diabetes and HbA1c, lack of training and presence of retinopathy increases the risk of diabetic foot ulcers.