Factors associated with diabetic patients at high risk for foot ulceration.

In order to define risk factors for foot ulcers, associated with the major contributing factors (peripheral sensorimotor neuropathy, peripheral vascular disease, altered foot biomechanics and history of foot ulceration or lower limb amputation), a multivariate analysis was performed in 446 patients free from foot ulceration. Four significant risk factors for foot ulcers have been identified: retinopathy, poor psychosocial status, hyperkeratosis, and diabetes duration. A relation was present between the probability of belonging to the high-risk groups and the number of associated factors. This study points out to the importance of screening especially in case of diabetes of long duration, with microvascular complications, and in socially-deprived people.