Prevalence of Foot Ulcers, Foot at Risk and Associated Risk Factors Among Jordanian Diabetics

Objective: To examine the prevalence of foot ulcers, foot at risk, and the associated risk factors among Jordanian diabetics. Methods: A cross-sectional design was applied on 1000 diabetes patients (both type-1 and type-2) aged >20 years. The participants were selected systematically from among every second patient visiting the diabetes clinics at National Center for Diabetes, Endocrinology, and Genetics (NCDEG) in Amman, Jordan. The participants were interviewed, examined, and then their medical records were reviewed. The factors including sensory neuropathy, vibratory neuropathy, painful neuropathy, vascular insufficiency, retinopathy, and dermatological changes were recorded for all patients. Foot at risk was identified based on the risk category classification and foot ulcers were evaluated based on the Wagner’s classification system. Results: A total of 53 (5.3%) patients had foot ulcers, 17 (1.7%) had undergone amputations, and 172 (17.2%) had foot at risk. A total of 62 patients were identified in the risk category-1, 82 in the risk category-2, and 28 in the risk category-3. Loss of protective sensation was detected in 174 (17.4%) patients, loss of vibratory sensation in 162 (16.2%) patients, absence of posterior tibial pulse in 115 (11.5%) patients, absence of dorsalis pedis pulse in 97 (9.7%) patients, and claudication in 72 (7.2%) patients. Loss of protective sensation (p < 0.000), loss of vibratory sensation (p < 0.039), and vascular insufficiency (p = 0.02) were found to be significantly higher in diabetic patients with foot ulcers than in those without foot ulcers. Conclusion: The prevalence of foot ulcer in Jordan was 5.3%, while foot at risk was prevalent in 17.2% patients. Patients with loss of protective sensation, loss of vibratory sensation, and vascular insufficiency of the lower limbs were found to be at a higher risk for the development of foot ulceration.