Risk Factors for the Development of Diabetic Foot Ulcers in Gaza Strip: A Case-Control Study

摘要

Background: Diabetic foot ulcers are significant health and socioeconomic problems, having negative effects on the quality of life and imposing a heavy economic burden on the patients and the community. Aims and Objectives: This study was conducted to identify the risk factors contributing to diabetic foot ulcers among diabetic patients in Gaza strip (Palestine). Materials and methods: Case-control, retrospective approach was used in this study, where 100 diabetic patients with foot ulcers and 100 controls (diabetic without foot ulcers) were selected from the surgical departments at the largest two governmental hospitals in Gaza. Both groups were matched for age and gender. By using questionnaire, the data were collected concerning main risk factors i.e. socio-demographic, lifestyle, and disease profile variables. Results: This study found several factors associated with higher incidence of diabetic foot ulcers including: low educational level (OR = 4.437; 95% CI: 2.351-8.374), low household income, type I diabetes, being on insulin treatment, longer duration of diabetes (more than 10 years), HbA1c ≥ 7% (OR=20.56; 95% CI: 9.89-42.76), being current smoker or ex-smoker, and lack of health education (OR = 42.29; 95% CI: 15.64–114.28). On the other hand, proper foot care activities [e.g., washing feet every day (OR= 0.479; p=0.004), examining feet regularly (OR = 0.476; p=0.002) and drying well between toes (OR = 0.324; p=0.000)] was a protective factor that decreases the chance of developing foot complications. Conclusions: Most of the identified risk factors were modifiable. Emphasis should be directed toward health education, changes in lifestyle, and following safety measures to decrease the higher incidence of diabetic foot complications in Gaza strip.