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Incidence of Diabetic Foot and Associated Risk Factors in Type 2 Diabetic Patients: A Five-year Observational Study.
Shin Ae Park, Seung Hyun Ko, Seung Hwan Lee, Jae Hyoung Cho, Sung Dae Moon, Sang A Jang, Hyun Shik Son, Ki Ho Song, Bong Yun Cha, Ho Young Son, Yu Bae Ahn
Korean Diabetes J. 2009;33(4):315-323.   Published online August 1, 2009
  • 2,554 View
  • 42 Download
  • 14 Crossref
AbstractAbstract PDF
The frequency of lower extremity amputation due to diabetic foot has been increasing in type 2 diabetic patients. The aim of this study was to observe the incidence, clinical aspects and associated risk factors for diabetic foot. METHODS: We evaluated the incidence of diabetic foot through a five-year observation of type 2 diabetic patients who presented to St. vincent's Hospital between January and December 2003. To identify the risk factors for diabetic foot, we evaluated mean glycosylated hemoglobin A1c (HbA1c) every six months and assessed renal function based on the existence of proteinuria and estimated glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) equation. Patients were also evaluated for retinopathy, peripheral neuropathy and autonomic neuropathy using Ewing's method. RESULTS: From an initial pool of 613 patients, the observational study of 508 patients (82.9%) was completed. The mean age, duration of diabetes and HbA1c were 50.3 +/- 10.6 yrs, 7.2 +/- 6.5 yrs and 8.8 +/- 2.1%, respectively. Diabetic foot occurred in 32 patients (6.3%). The incidence of diabetic foot increased when diabetic retinopathy (OR = 6.707, 2.314~19.439), peripheral neuropathy (OR = 2.949, 1.075~8.090), and autonomic neuropathy (OR = 3.967, 1.476~10.660) were present and when the MDRD GFR (OR = 5.089, 1.712~15.130) decreased. Mean HbA1c (OR = 12.013, 1.470~98.179) was found to be an independent risk factor for diabetic foot. CONCLUSION: The present study confirmed the importance of intensive glycemic control and the role of autonomic dysfunction in the development of diabetic foot. In addition, diabetic retinopathy and impaired renal function proved to be factors associated with the occurrence of diabetic foot. Therefore, intensive glycemic control, as well as periodic examination of renal function, are essential for the prevention of diabetic foot.


Citations to this article as recorded by  
  • The Risk of the Aggravation of Diabetic Foot According to Air Quality Factors in the Republic of Korea: A Nationwide Population-Based Study
    Saintpee Kim, Sungho Won, Young Yi
    International Journal of Environmental Research and Public Health.2024; 21(6): 775.     CrossRef
  • Microbiological, Clinical and Radiological Aspects of Diabetic Foot Ulcers Infected with Methicillin-Resistant and -Sensitive Staphylococcus aureus
    Maria Stańkowska, Katarzyna Garbacz, Anna Korzon-Burakowska, Marek Bronk, Monika Skotarczak, Anna Szymańska-Dubowik
    Pathogens.2022; 11(6): 701.     CrossRef
  • Potential of Nanoencapsulated Quercetin Topical Formulations in the Management of Diabetic Foot Ulcer
    Shashank Chaturvedi, Shruti Agrawal, Anuj Garg, Vaibhav Rastogi
    Revista Brasileira de Farmacognosia.2022; 33(3): 484.     CrossRef
  • Development of a Diabetic Foot Ulceration Prediction Model and Nomogram
    Eun Joo Lee, Ihn Sook Jeong, Seung Hun Woo, Hyuk Jae Jung, Eun Jin Han, Chang Wan Kang, Sookyung Hyun
    Journal of Korean Academy of Nursing.2021; 51(3): 280.     CrossRef
  • Regional Variation in the Incidence of Diabetes-Related Lower Limb Amputations and Its Relationship with the Regional Factors
    Sung Hun Won, Jahyung Kim, Dong-Il Chun, Young Yi, Suyeon Park, Kwang-Young Jung, Gun-Hyun Park, Jaeho Cho
    Journal of Korean Foot and Ankle Society.2019; 23(3): 121.     CrossRef
  • The Changes of Trends in the Diagnosis and Treatment of Diabetic Foot Ulcer over a 10-Year Period: Single Center Study
    Choong Hee Kim, Jun Sung Moon, Seung Min Chung, Eun Jung Kong, Chul Hyun Park, Woo Sung Yoon, Tae Gon Kim, Woong Kim, Ji Sung Yoon, Kyu Chang Won, Hyoung Woo Lee
    Diabetes & Metabolism Journal.2018; 42(4): 308.     CrossRef
  • The Relationship between Body Mass Index and Diabetic Foot Ulcer, Sensory, Blood Circulation of Foot on Type II Diabetes Mellitus Patients
    Yi Kyu Park, Jun Young Lee, Sung Jung, Kang Hyeon Ryu
    Journal of the Korean Orthopaedic Association.2018; 53(2): 136.     CrossRef
  • Factors Contributing to Diabetic Foot Ulcer among Patients with Type 2 Diabetes Mellitus
    Seo Jin Park, Taeyoung Yang, Jun Young Lee, Jinhee Kim
    Korean Journal of Adult Nursing.2018; 30(1): 106.     CrossRef
  • A Report on Diabetic Foot and Amputation from the Korean Health Insurance Review & Assessment Service Data
    Jong-Kil Kim, Young-Ran Jung, Kyung-Tae Kim, Chung-Shik Shin, Kwang-Bok Lee
    Journal of Korean Foot and Ankle Society.2017; 21(2): 66.     CrossRef
  • Prevalence and Current Status of Treatment of Diabetic Foot in South Korea
    Jae-Ik Bae, Je Hwan Won, Jun Su Kim, Man Deuk Kim, Chang Jin Yoon, Yun Ku Cho
    Journal of the Korean Society of Radiology.2016; 74(3): 169.     CrossRef
  • Diabetic Foot Disease—Incidence and Risk Factors: A Clinical Study
    Rajesh Kapila, Rakesh Sharma, Ashwani K Sharma, Jagsir Mann
    Journal of Foot and Ankle Surgery (Asia Pacific).2016; 3(1): 41.     CrossRef
  • Diabetic Peripheral Neuropathy in Type 2 Diabetes Mellitus in Korea
    Seung-Hyun Ko, Bong-Yun Cha
    Diabetes & Metabolism Journal.2012; 36(1): 6.     CrossRef
  • Diabetics' Preference in the Design Factors and Performance Requirements of Diabetic Socks
    Ji-Eun Lee, Young-Ah Kwon
    Journal of the Korean Society of Clothing and Textiles.2011; 35(5): 527.     CrossRef
  • Epidemiology of Diabetic Foot Disease
    Kyu Jeung Ahn
    Journal of Korean Diabetes.2011; 12(2): 72.     CrossRef
The Combination of Fasting Plasma Glucose and Glycosylated Hemoglobin as a Predictor for Type 2 Diabetes in Korean Adults.
Chan Hee Lee, Woo Jin Chang, Hyun Hee Chung, Hyun Jung Kim, Sang Hyun Park, Jun Sung Moon, Ji Eun Lee, Ji Sung Yoon, Kyung Ah Chun, Kyu Chang Won, Ihn Ho Cho, Hyoung Woo Lee
Korean Diabetes J. 2009;33(4):306-314.   Published online August 1, 2009
  • 3,214 View
  • 24 Download
  • 8 Crossref
AbstractAbstract PDF
The oral glucose tolerance test (OGTT) for detection of diabetes is difficult to perform in clinical settings. The aim of this study is to evaluate the performance of a more practical detection test, combined fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c), as a predictor of diabetes mellitus (DM) in a Korean sample. METHODS: We examined 2,045 (M = 1,276, mean age = 47.8 +/- 9.0 yrs) medical check-up program participants between January 2002 to December 2003. FPG, HbA1c and a number of other biochemical tests were performed at baseline and four after years after initial screening. Patients who originally presented with diabetes were excluded. The characteristics of newly-diagnosed DM patients and non-diabetic patients were compared. RESULTS: The incidence of newly diagnosed diabetes was 1.6% (32/2,045) after four years of follow up. The subjects in the DM group were older, had higher levels of SBP, DBP, FPG, HbA1c, triglyceride, HDL cholesterol, GGT and LDH (P < 0.05). In multivariate logistic regression analysis, FPG (odds ratio [OR] 1.124) and HbA1c (OR 4.794) were significantly correlated with onset of diabetes (P < 0.05). The interaction parameter between FPG and HbA1c was more than 1.0, indicating that the two effects are synergistic. The predictive cut-off values of HbA1c and FPG were 5.35% (area under curve [AUC] = 0.944) and 102.5 mg/dL (AUC = 0.930), respectively. CONCLUSION: The combination of HbA1c above 5.35% and FPG above 102.5 mg/dL predicted the onset of diabetes in a Korean sample. These results suggest that the combination of FPG and HbA1c may be useful for predicting progression to type 2 diabetes in east Asians.


Citations to this article as recorded by  
  • The Distribution and Characteristics of Abnormal Findings Regarding Fasting Plasma Glucose and HbA1c - Based on Adults Except for Known Diabetes
    Seyoung Kwon, Youngak Na
    The Korean Journal of Clinical Laboratory Science.2017; 49(3): 239.     CrossRef
  • Factors Affecting Diabetic Screening Behavior of Korean Adults: A Multilevel Analysis
    Hyeongsu Kim, Minjung Lee, Haejoon Kim, Kunsei Lee, Sounghoon Chang, Vitna Kim, Jun Pyo Myong, Soyoun Jeon
    Asian Nursing Research.2013; 7(2): 67.     CrossRef
  • Impact of HbA1c Criterion on the Detection of Subjects with Increased Risk for Diabetes among Health Check-Up Recipients in Korea
    Hong-Kyu Kim, Sung-Jin Bae, Jaeone Choe
    Diabetes & Metabolism Journal.2012; 36(2): 151.     CrossRef
  • The Utility of HbA1c as a Diagnostic Criterion of Diabetes
    Hee-Jung Kim, Eun Young Choi, Eal Whan Park, Yoo Seock Cheong, Hong-Yoen Lee, Ji Hyun Kim
    Korean Journal of Family Medicine.2011; 32(7): 383.     CrossRef
  • Predictive Clinical Parameters for the Therapeutic Efficacy of Sitagliptin in Korean Type 2 Diabetes Mellitus
    Soon Ae Kim, Woo Ho Shim, Eun Hae Lee, Young Mi Lee, Sun Hee Beom, Eun Sook Kim, Jeong Seon Yoo, Ji Sun Nam, Min Ho Cho, Jong Suk Park, Chul Woo Ahn, Kyung Rae Kim
    Diabetes & Metabolism Journal.2011; 35(2): 159.     CrossRef
  • Optimal range of HbA1c for the prediction of future diabetes: A 4-year longitudinal study
    Ji Cheol Bae, Eun Jung Rhee, Won Young Lee, Se Eun Park, Cheol Young Park, Ki Won Oh, Sung Woo Park, Sun Woo Kim
    Diabetes Research and Clinical Practice.2011; 93(2): 255.     CrossRef
  • The Combination of Fasting Plasma Glucose and Glycosylated Hemoglobin as a Predictor for Type 2 Diabetes in Korean Adults (Korean Diabetes J 33(4):306-314, 2009)
    Soo Lim
    Korean Diabetes Journal.2009; 33(5): 448.     CrossRef
  • The Combination of Fasting Plasma Glucose and Glycosylated Hemoglobin as a Predictor for Type 2 Diabetes in Korean Adults (Korean Diabetes J 33(4):306-314, 2009)
    Chan Hee Lee, Hyoung Woo Lee
    Korean Diabetes Journal.2009; 33(5): 451.     CrossRef

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