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Assessment of the association between lifestyle-related risk factors and development of foot ulcers among male Saudi diabetic patients in Riyadh KSA, 2007


Foot disease, mainly foot ulcers is a common complication of diabetes that can lead to amputation which is considered a major cause of morbidity, disability, as well as emotional and physical costs for people with diabetes. Diabetic foot ulcer became a common heath problem presented in Saudi diabetic patients, particularly among men. The study was conducted to estimate the proportions of lifestyle-related risk factors (smoking, overweight, lack of activity and dietary habits) and other associated health conditions among Saudi diabetic men in Riyadh, then to measure the association between these risk factors and occurrence of foot ulcer among the patients.


A case-control study was conducted among Saudi males diabetic patients registered at the diabetic clinics of primary health care centers of Riyadh. The study included 333 Saudi diabetic men as a representative sample from randomly selected 20 primary health care centers in Riyadh, 111 of them represented case sample (diabetics with foot ulcer), and 222 represented control sample (diabetics without foot ulcer). Detailed information of each patients' age, occupation, education level, body mass index, type and duration of diabetes mellitus, mode of treatment, degree of blood glucose control, presence of hypertension, hyperlipidemia, smoking, physical activity, type of used shoes and dietary habits were recorded.


A total of studied 333 patients were with mean age of 62 years (SD + 11 years) and mean duration of diagnosed diabetes 14 years (SD + 5.5 years). The prevalence of insulin dependent type of diabetes among cases was 28.8% and 5.9% among controls, the average prevalence of uncontrolled blood glucose during the latest 6 months was 82 % among cases and 42.4% among controls. Smoking, hyperlipidemia, hypertension and obesity had prevalence of 39.6%, 23.4%, 32.4% and 64% among cases respectively and a prevalence of 26.1%, 14.0%, 31.5% and 61.3% among controls respectively. A statistical significance of elevated risk for developing foot ulcer in diabetics was associated with insulin dependent DM (OR=6.51, 95% CI=3.1-13.86), poorly controlled blood sugar (OR= 6.2, 95% CI=3.45-11.20), hyperlipidemia (OR=1.88, 95% CI=1.01-3.50) and smoking (OR=1.86, 95% CI=1.11-3.10).


Insulin dependent type of DM, Prolonged poorly controlled blood glucose, high level of cholesterol and smoking were found risk factors associated with development of foot ulcers among Saudi diabetic males in Riyadh.