Determinants of diabetic foot ulcer among adult patients with diabetes attending the diabetic clinic in tikur anbessa specialized hospital, addis ababa, ethiopia: Unmatched case–control study

Abstract

Background: Diabetic foot ulcer is among the commonest complications of diabetic mellitus attributed to a number of morbidity and mortality cases in diabetic patients. Nowadays, the incidence of diabetic foot ulcer is increasing due to the increased prevalence of diabetes. However, the risk factors of the problem are less studied in Ethiopia. Hence, this study was conducted to assess the determinants of diabetic foot ulcer among adult patients with diabetes attending a diabetic clinic in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia in 2019. Patients and Methods: An institution-based unmatched case–control study was conducted on 161 patients with diabetes (53 patients with diabetes with foot ulcer and 108 patients with diabetes without foot ulcer). Cases were selected from patients with diabetes with foot ulcer by consecutive sampling technique and controls from patients with diabetes without diabetic foot ulcer by systematic random sampling technique. A binary logistic regression model was used to assess the association between the dependent and independent variables. All variables with a P-value<0.25 were included in the multivariable analysis. Statistical significance was declared at P-value<0.05 with 95% confidence interval. Results: In this study, 28 (52.8%) cases and 55 (50.9%) controls were male. Taking insulin alone (AOR=2.75, 95% CI=1.04–7.23), having peripheral neuropathy (AOR=7.56, 95% CI=2.82–20.24), not inspecting feet daily (AOR=5.61, 95% CI=2.24–14.05), and using moisturizing cream between toes (AOR=3.35, 95% CI=1.35–8.32) were positively associated with diabetic foot ulcer, whereas employed (AOR=0.35, 95% CI=0.14–0.87) and combined treatment (insulin and oral hypoglycemic agents) (AOR=0.11, 95% CI=0.02–0.57) were negatively associated with diabetic foot ulcer. Conclusion: Diabetic foot ulcer was significantly associated with occupation, kind of treatment of diabetes mellitus taking, peripheral neuropathy, inspecting feet daily, and putting moisturizing cream between toes. It will be helpful if diabetic patients inspect their feet on a daily basis and do not put moisturizing cream between their toes.