| Diabetic foot (DF) is a serious complication of diabetes mellitus and can have potentially adverse consequences for life and limb. A comprehensive understanding of risk factors for developing diabetic foot is valuable in identifying persons whose feet are at risk, effectively preventing and treating foot ulcerations and ultimately preventing lower extremity amputation.Objective: To identify risk factors for diabetic foot among patients with Type 2 diabetes mellitus.Method: A hospital-based 1:1 pair -matched case-control study was conducted at the Metabolic Diseases Hospital of Tianjin Medical University and the First Teaching Hospital of Tianjin Traditional Chinese Medicine College, where 115 patients with diabetic foot and 115 controls with Type 2 diabetes mellitus were interviewed. Case subjects were matched with controls on sex and age within 5 years. Conditional logistic regression model and ordinal-response logistic regression were used for analysis.Results: Results from univariate analysis showed that high level of education (OR=0.197 95% CI 0.085-0.458), manual occupation (OR=8.001 95% CI 3.425-18.691), family mean income (OR=0.391 95% CI 0.241-0.634), age at onset of diabetes (OR=0.491 95% CI 0.311-0.776), longer duration of diabetes (for every 10 years of diabetes OR=2.574 95% CI 1.568-4.225), treat with diet (OR= 0.333 95% CI 0.121-0.917), treat with oral tablets ( OR=0.118 95% CI 0.027-0.509 ), history of stroke (OR=2.091 95% CI 1.019- 4.289), diabeticretinopathy (DR) (OR=3.463 95% CI 2.144-5.592), diabetic nephropathy (DN) (OR=4.535 95% CI 2.558-8.038) , peripheral vascular disease (PVD) (OR=1.960 95% CI 1.340-2.867), sensory loss (OR=18.000 95% CI 5.628-57.568) ,callus (OR=4.900 95% CI 2.482-9.673), foot deform (OR=3.429 95% CI 1.890-6.218 ), smoke (OR=2.058 95% CI 1.416-2.99l),alcohol drinking (OR=2.333 95% CI 1.187-4.588 ), intake of carbohydrate (OR= 3.727 95% CI 1.837-7.561), intake of fruit (OR=4.245 95% CI 2.099-8.587), intake of high fat (OR= 3.108 95% CI 1.192-8.108), intake of milk (OR= 0.420 95% CI 0.288-0.612), hypertension (OR-1.895 95% CI 1.087-3.303), elevated fasting plasma glucose (FPG) (OR= 1.436 95% CI 1.265-1.630), elevated HbAlic (for every percent point increase OR=3.914 95% CI 2.238-6.845) , low level of high density lipoprotein cholesterol (HDL-C) (OR=2.922 95% CI 1.776-4.810), elevated triglyceride (TG) (OR= 0.701 95% CI 0.508-0.968 ) ,high level of fibrinogen (FIB) (OR= 2.875 95% CI 1.956-4.226), high level of blood urea nitrogen (BUN) (OR=2.643 95% CI 1.429-4.888 ), elevated creatinine (CR) (OR=2.250 95% CI 1.140- 4.441)were significantly associated with diabetic foot. No significant associations were noted between diabetic foot and marital status, treat with insulin, diabetic knowledge, intake of vegetables, intake of meat, intake of egg, history of coronary heart disease (CHD), family history of diabetes, hypertension, stroke and CHD, height, weight, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBF), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C). Multiple stepwise logistic regression analysis indicated that the risk of developing diabetic foot was significantly associated with six factors which were sensory loss (OR=12.626 95% CI 1.252-127.306), elevated HbAlc level (for every percent point increase 1% OR= 3.871 95% CI 1.834-8.170), peripheral vascular disease (OR=4.2248 95% CI 1.295-13.939), smoke (OR=3.52595% CI 1.182-8.948), diabetic retinopathy (OR=3.090 95% CI 1.107-8.621) andlow level of HDL-C (OR=3.094 95% CI 1.118-8.546).Conclusion: Peripheral neuropathy, poor glycaemic control, peripheral vasculardisease, smoke, diabetic retinopathy and low level of HDL-C are significantlyassociated with the risk of developing diabetic foot in patients with Type 2diabetes mellitus. Diabetic foot may be related to multiple risk factors.
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