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Foot ulcer risk is lower in South-Asian and African-Caribbean compared with European diabetic patients in the UK: the North-West diabetes foot care study

Abbott, CA, Garrow, A, Carrington, AL, Morris, J, van Ross, ER and Boulton, AJM 2005, 'Foot ulcer risk is lower in South-Asian and African-Caribbean compared with European diabetic patients in the UK: the North-West diabetes foot care study' , Diabetes Care, 28 (8) , pp. 1869-1875.

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    Abstract

    OBJECTIVE: To determine 1) foot ulcer rates for European, South-Asian, and African-Caribbean diabetic patients in the U.K and 2) the contribution of neuropathy and peripheral arterial disease (PAD) differences to altered ulcer risk between the groups. RESEARCH DESIGN AND METHODS: In this U.K. population–based study, we screened 15,692 type 1 and type 2 diabetic patients in the community health care setting for foot ulcers, foot deformities, neuropathy, and PAD plus other characteristics. In total, 13,409 were European (85.5%), 1,866 were South Asian (11.9%), and 371 were African Caribbean (2.4%). RESULTS: The age-adjusted prevalence of diabetic foot ulcers (past or present) for Europeans, South Asians, and African Caribbeans was 5.5, 1.8, and 2.7%, respectively (P < 0.0001). Asians and African Caribbeans had less neuropathy, PAD, and foot deformities than Europeans (P = 0.003). The unadjusted risk of ulcer (odds ratio [OR]) for Asians versus Europeans was 0.29 (95% CI 0.20–0.41) (P < 0.0001). PAD, neuropathy, foot deformities, and insulin use attenuated the age-adjusted OR from 0.32 to 0.52 (0.35–0.76) (P < 0.0001). African-Caribbean versus European ulcer risk in males was attenuated from 0.60 to 0.71 by vibration sensation. CONCLUSIONS: South Asians with diabetes in the U.K. have about one-third the risk of foot ulcers of Europeans. The lower levels of PAD, neuropathy, insulin usage, and foot deformities of the Asians account for approximately half of this reduced foot ulcer risk. Lower neuropathy is the main contributor to the reduced African-Caribbean ulcer rate, particularly in men. The reasons for these ethnic differences warrant further investigation. Abbreviations: NWDFCS, North-West Diabetes Foot Care Study; PAD, peripheral arterial disease

    Item Type: Article
    Themes: Subjects / Themes > H Social Sciences > HT Communities. Classes. Races
    Subjects / Themes > R Medicine > R Medicine (General)
    Health and Wellbeing
    Subjects outside of the University Themes
    Schools: Colleges and Schools > College of Health & Social Care
    Colleges and Schools > College of Health & Social Care > School of Nursing, Midwifery, Social Work & Social Sciences > Centre for Social Justice Research
    Journal or Publication Title: Diabetes Care
    Publisher: American Diabetes Association
    Refereed: Yes
    ISSN: 01495992
    Depositing User: H Kenna
    Date Deposited: 07 Aug 2007 08:52
    Last Modified: 20 Aug 2013 16:45
    URI: http://usir.salford.ac.uk/id/eprint/116

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