Health-related quality of life among patients with diabetes and foot ulcers: association with demographic and clinical characteristics

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Health-related quality of life among patients with diabetes and foot ulcers: association with demographic and clinical characteristics
Received 25 December 2005;
revised 9 October 2006;
accepted 19 January 2007.
Available online 4 July 2007.
Lis Ribua, Corresponding Author Contact Information, E-mail The Corresponding Author, Berit Rokne Hanestadb, Torbjorn Moumc, Kåre Birkelandd, e and Tone Rustoena
Journal of Diabetes and its Complications
ScienceDirect

Copyright © 2007 Published by Elsevier Inc.

aOslo University College, Faculty of Nursing, 0130 Oslo, Norway

bDepartment of Public Health and Primary Health Care, University of Bergen, 5020 Bergen, Norway

cDepartment of Behavioural Sciences in Medicine, University of Oslo, 0317 Oslo, Norway

dDiabetes Research Center, Aker and Ullevaal University Hospital, 0407 Oslo, Norway

eFaculty Division, Aker University Hospital, University of Oslo, 0318 Oslo, Norway

Abstract
Objective

The purpose of the study was to describe the sociodemographic variables, clinical characteristics, and treatment factors in patients with diabetic foot ulcers (DFU) and to explore the associations between these factors and the patients' health-related quality of life (HRQL).
Materials and methods

Cross-sectional data were obtained from 127 patients consecutively recruited from six hospital outpatient clinics. The patients were over 20 years of age, had current DFU, and had been diagnosed with diabetes of either Type 1 or Type 2. Data were obtained by clinical and laboratory examination and by self-completed questionnaires (SF-36). Descriptive analyses, bivariate analyses, and hierarchical regression analyses in three blocks were performed.
Results

The patients' mean age was 60 years (S.D., 13.8 years); 72% were men, and 29% had Type 1 diabetes. The most important variables explaining the variance in HRQL were the presence of biochemical signs of inflammation as measured by the detection of C-reactive protein (CRP) >10 mg/l, an ankle–brachial index (ABI) <0.9, an ulcer size &#8805;5 cm2, nephropathy, and a body mass index <25 kg/m2. The strongest association occurred between biochemical signs of inflammation CRP >10 mg/l, ABI <0.9, ulcer size >5cm2, and HRQL on physical functioning (adjusted r2=24). A major part of the variance remained unexplained and should be investigated in future studies.
Conclusion

The findings may tend to identify the most vulnerable subgroups among those with DFU and may be useful in the formulation of strategies to improve function and HRQL in these patients.

Keywords: Diabetes; Diabetic foot ulcers; Health-related quality of life

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