Risk factors for Charcot foot

Objective: To identify the risk factors for acute Charcot foot (ACF) in patients with type 2 diabetes mellitus. Research Design and Methods: Case-control study of 575 patients with type 2 diabetes and foot ulcers. Results: The cohort characteristics were as follows: age: 62.4±12.4 years old; family income: 2.2±1.87 times the minimum wage; male: 51.7%; white: 56.7%; illiterate: 36.1%; social isolation: 11.8%; time since diabetes diagnosis: 10.9±7.4 years; hypertension: 65.6%; past ulcer history: 49.9%; obesity: 22.1%; neuropathy: 83.3%; brachial pressure: 153.4±30.1 mmHg; left and right leg pressure: 146.25±65.0 mmHg and 151.3±66.3 mmHg, respectively; ischemia: 36.2%; and blood glucose: 228±117.0 mg/dl. The ACF prevalence was 6.6%, and the risk factors included the following: male gender 68.4 vs. 50.5% (odds ratio [OR] 2.13; confidence interval [CI] 1.22-4.99); younger age 53.7 vs. 63 years old (p<0.001; CI 1.71-5.86); past ulcer history 75 vs. 48.2% (OR 3.23; CI 1.49-7.0); taller height 1.65 m vs. 1.59 m (p<0.001; CI -0.089 – -0.03); heavier weight 78.4 kg vs. 67.3 (p<0.001; CI -15.8 – -6.32); high blood glucose 277 vs. 223 mg/dl (p<0.01 CI 94.5–14.0); and higher pressure in the right (182 vs. 148 mmHg; p=0.03; CI -59.5 – -9.07) and left ankles (171 vs. 144 mmHg; p≤0.01; CI -51.8 – -2.90). The adjusted OR values calculated on a logistic regression were age 0.93 (p=0.002; CI 0.91-0.97); male gender 2.10 (p=0.011; CI 1.01-4.39); and past ulcer history 3.77 (p=0.013; CI 1.67-8.38). Conclusions: The results suggest that among patients with type 2 diabetes, ACF affects mainly the youngest males with a past ulcer history.