High Rates of Comorbid Conditions in Patients With Type 2 Diabetes and Foot Ulcers
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Foot ulceration in patients with diabetes mellitus (DM) affects quality of life and creates a significant economic burden for both the patient and healthcare systems worldwide.1–3 The annual incidence of foot ulcers is 1%–4% while the prevalence is 5%–10% in patients with DM.1,4 The lifetime risk for foot ulcers development in patients with diabetes is nearly 15%,1 and frequently leads to disability and leg amputation.1,2 The link between foot ulcers and leg amputations is indisputable, as diabetes is the cause of almost 50% of all nontraumatic lower extremity amputations worldwide.1,5
Patients with diabetes and lower extremity arterial disease (LEAD) have approximately a 10-year reduction in life expectancy and a 2-fold increase in mortality compared to patients without LEAD.6,7 Previous studies have shown consistently increased mortality rates after amputations, with cardiovascular disease to be the leading cause of death.8,9 In addition, recent data have shown high mortality rates in patients with foot ulcers9— patients with ischemic ulcers have the highest mortality followed by those with neuroischemic and neuropathic ulcers.8,9 Although it is expected that patients with peripheral vascular disease will probably develop other macrovascular complications such as coronary (CAD) and carotid artery disease,6,7 the reason for the high mortality among patients with neuropathic foot ulcers is not known. Increased prevalence of comorbid conditions could be a possible explanation for the high mortality rates in patients with diabetes and foot ulcers; however, this hypothesis has not been examined. Therefore, the aim of this cross-sectional study was to investigate the prevalence rates of comorbid conditions in patients with both diabetes and neuropathic and neuroischemic foot ulcers.
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