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Parisi MC, Moura Neto A, Menezes FH, et al. Baseline characteristics and risk factors for ulcer, amputation and severe neuropathy in diabetic foot at risk: the BRAZUPA study. Diabetol Metab Syndr. 2016;8:25doi: 10.1186/s13098-016-0126-8.
Parisi, M. C., Moura Neto, A., Menezes, F. H., Gomes, M. B., Teixeira, R. M., de Oliveira, J. E., Pereira, J. R., Fonseca, R. M., Guedes, L. B., Costa E Forti, A., de Oliveira, A. M., de Medeiros Nóbrega, M. B., Colares, V. N., Schmid, H., Nienov, O. H., Nery, M., Fernandes, T. D., Pedrosa, H. C., Schreiber de Oliveira, C. d. a. . S., Ronsoni, M., Rezende, K. F., Quilici, M. T., Vieira, A. E., de Macedo, G. M., Stuchi-Perez, E. G., Dinhane, K. G., Pace, A. E., de Freitas, M. C., Calsolari, M. R., & Saad, M. J. (2016). Baseline characteristics and risk factors for ulcer, amputation and severe neuropathy in diabetic foot at risk: the BRAZUPA study. Diabetology & metabolic syndrome, 825. https://doi.org/10.1186/s13098-016-0126-8
Parisi, Maria Candida R, et al. "Baseline characteristics and risk factors for ulcer, amputation and severe neuropathy in diabetic foot at risk: the BRAZUPA study." Diabetology & metabolic syndrome vol. 8 (2016): 25. doi: https://doi.org/10.1186/s13098-016-0126-8
Parisi MC, Moura Neto A, Menezes FH, Gomes MB, Teixeira RM, de Oliveira JE, Pereira JR, Fonseca RM, Guedes LB, Costa E Forti A, de Oliveira AM, de Medeiros Nóbrega MB, Colares VN, Schmid H, Nienov OH, Nery M, Fernandes TD, Pedrosa HC, Schreiber de Oliveira Cda S, Ronsoni M, Rezende KF, Quilici MT, Vieira AE, de Macedo GM, Stuchi-Perez EG, Dinhane KG, Pace AE, de Freitas MC, Calsolari MR, Saad MJ. Baseline characteristics and risk factors for ulcer, amputation and severe neuropathy in diabetic foot at risk: the BRAZUPA study. Diabetol Metab Syndr. 2016 Mar 17;8:25. doi: 10.1186/s13098-016-0126-8. eCollection 2016. PMID: 26989446; PMCID: PMC4794830.
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Diabetol Metab Syndr. 2016 Mar 17;8:25. doi: 10.1186/s13098-016-0126-8. eCollection 2016.

Baseline characteristics and risk factors for ulcer, amputation and severe neuropathy in diabetic foot at risk: the BRAZUPA study.

Diabetology & metabolic syndrome

Maria Candida R Parisi, Arnaldo Moura Neto, Fabio H Menezes, Marilia Brito Gomes, Rodrigo Martins Teixeira, José Egídio Paulo de Oliveira, Joana Rodrigues Dantas Pereira, Reine Marie Chaves Fonseca, Lorena Barreto Arruda Guedes, Adriana Costa E Forti, Ana Mayra Andrade de Oliveira, Marta Barreto de Medeiros Nóbrega, Víctor Nóbrega Quintas Colares, Helena Schmid, Otto Henrique Nienov, Marcia Nery, Túlio Diniz Fernandes, Hermelinda C Pedrosa, Cristina da S Schreiber de Oliveira, Marcelo Ronsoni, Karla Freire Rezende, Maria Teresa Verrone Quilici, Alexandre Eduardo Franzin Vieira, Geisa Maria Campos de Macedo, Eliana Gabas Stuchi-Perez, Kandir Genésio Innocenti Dinhane, Ana Emilia Pace, Maria Cristina Foss de Freitas, Maria Regina Calsolari, Mario José Abdalla Saad

Affiliations

  1. Faculty of Medical Sciences, State University of Campinas, Campinas, SP 13083-887 Brazil ; Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
  2. Faculty of Medical Sciences, State University of Campinas, Campinas, SP 13083-887 Brazil.
  3. Unity of Diabetes, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
  4. Department of Nutrology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
  5. Centre for Diabetes and Endocrinology in the State of Bahia (CEDEBA), Salvador, Brazil.
  6. Centro Integrado de diabetes e Hipertensão do Ceará, Fortaleza, Brazil.
  7. State University of Feira de Santana, Feira de Santana, Brazil.
  8. Federal University of Campina Grande, Campina Grande, Brazil.
  9. Hospital das Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS Brazil ; Santa Casa de Porto Alegre, Porto Alegre, RS Brazil.
  10. Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
  11. Hospital Regional de Taguatinga, Brasília, Brazil.
  12. Faculdade de Medicina, Federal University of Santa Catarina, Florianopolis, Brazil.
  13. Federal University of Sergipe, São Cristóvão, Brazil.
  14. Pontifícia Universidade Católica de Sorocaba, Sorocaba, Brazil.
  15. Division of Endocrinology, Hospital Agamenon Magalhães, Recife, Brazil.
  16. Faculdade de Medicina de Catanduva, Catanduva, Brazil.
  17. Faculdade de Medicina de Botucatu, UNESP, Botucatu, Brazil.
  18. Universidade de São Paulo, Faculdade de Medicina, Ribeirão Preto, Brazil.
  19. Santa Casa de Belo Horizonte, Belo Horizonte, Brazil.

PMID: 26989446 PMCID: PMC4794830 DOI: 10.1186/s13098-016-0126-8

Abstract

BACKGROUND: Studies on diabetic foot and its complications involving a significant and representative sample of patients in South American countries are scarce. The main objective of this study was to acquire clinical and epidemiological data on a large cohort of diabetic patients from 19 centers from Brazil and focus on factors that could be associated with the risk of ulcer and amputation.

METHODS: This study presents cross sectional, baseline results of the BRAZUPA Study. A total of 1455 patients were included. Parameters recorded included age, gender, ethnicity, diabetes and comorbidity-related records, previous ulcer or amputation, clinical symptomatic score, foot classification and microvascular complications.

RESULTS: Patients with ulcer had longer disease duration (17.2 ± 9.9 vs. 13.2 ± 9.4 years; p < 0.001), and poorer glycemic control (HbA1c 9.23 ± 2.03 vs. 8.35 ± 1.99; p < 0.001). Independent risk factors for ulcer were male gender (OR 1.71; 95 % CI 1.2-3.7), smoking (OR 1.78; 95 % CI 1.09-2.89), neuroischemic foot (OR 20.34; 95 % CI 9.31-44.38), region of origin (higher risk for those from developed regions, OR 2.39; 95 % CI 1.47-3.87), presence of retinopathy (OR 1.68; 95 % CI 1.08-2.62) and absence of vibratory sensation (OR 7.95; 95 % CI 4.65-13.59). Risk factors for amputation were male gender (OR 2.12; 95 % CI 1.2-3.73), type 2 diabetes (OR 3.33; 95 % CI 1.01-11.1), foot at risk classification (higher risk for ischemic foot, OR 19.63; 95 % CI 3.43-112.5), hypertension (lower risk, OR 0.3; 95 % CI 0.14-0.63), region of origin (South/Southeast, OR 2.2; 95 % CI 1.1-4.42), previous history of ulcer (OR 9.66; 95 % CI 4.67-19.98) and altered vibratory sensation (OR 3.46; 95 % CI 1.64-7.33). There was no association between either outcome and ethnicity.

CONCLUSIONS: Ulcer and amputation rates were high. Age at presentation was low and patients with ulcer presented a higher prevalence of neuropathy compared to ischemic foot at risk. Ischemic disease was more associated with amputations. Ethnical differences were not of great importance in a miscegenated population.

Keywords: Amputation; Brazil; Diabetes; Risk factors for ulcer; Severe neuropathy

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