News & Research

High levels of foot ulceration and amputation risk in a multiracial cohort of diabetic patients on dialysis therapy, by Agbor Ndip and colleagues. Diabetes Care 33:878–880, 2010

What is the problem and what is known about it so far?

Foot problems are common among people with diabetes. Most often, they occur because of nerve damage or poor blood circulation in the feet and legs. People with diabetes can develop serious ulcers (open sores) on their feet that are likely to get infected and are difficult to heal. As a result, people with diabetes are more likely than others to eventually need foot or leg amputations. Studies have shown that diabetic foot problems are more common among some ethnic groups than others. Studies have also found links between foot problems and other complications of diabetes, such as kidney disease. More study is needed to fully understand such links and how they may help to identify those in need of help to avoid foot problems and amputations.

Why did the researchers do this particular study?

The researchers wanted to learn more about how frequent foot problems are among people from different ethnic groups who have diabetes and advanced kidney disease.

Who was studied?

The study included 466 patients with diabetes from different ethnic backgrounds in the United States and the United Kingdom. The patients were receiving dialysis therapy for kidney failure.

How was the study done?

Patients were interviewed and had detailed foot exams during their routine clinic visits. Researchers also collected information about their diabetes, the type of dialysis treatment they were receiving, and their ethnic background. Researchers then grouped the patients by their level of risk for foot problems and looked to see whether patients from different ethnic groups were more or less likely to have foot problems.

What did the researchers find?

Foot problems were very common among all patients. Ninety-five percent of the patients were at high risk for getting foot problems. The only difference related to ethnicity was that white patients were more likely to have foot ulcers than patients of African descent.

What were the limitations of the study?

The study was limited by the small number of patients receiving one type of dialysis treatment and researchers’ inability to collect complete information about their preventive care and treatment.

What are the implications of the study?

All patients with diabetes who are receiving dialysis for kidney disease are at high risk for foot problems, regardless of their ethnic background. Diabetic foot care should be offered to all such patients as part of their dialysis services.

FOR MORE INFORMATION

Foot Complications of Diabetes

Diabetes and Kidney Disease

ADA’s Uncomplicated Guide to Diabetes Complications