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The foot-health of people with diabetes in regional and rural Australia: baseline results from an observational cohort study

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Perrin, BM, Allen, P ORCID: 0000-0003-1945-8049, Gardner, MJ, Chappell, A, Phillips, B, Massey, C, Skinner, I and Skinner, TC 2019 , 'The foot-health of people with diabetes in regional and rural Australia: baseline results from an observational cohort study' , Journal of Foot and Ankle Research, vol. 12 , pp. 1-9 , doi: 10.1186/s13047-019-0366-6.

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Abstract

Background: There is limited Australian epidemiological research that reports on the foot-health characteristics ofpeople with diabetes, especially within rural and regional settings. The objective of this study was to explore theassociations between demographic, socio-economic and diabetes-related variables with diabetes-related footmorbidity in people residing in regional and rural Australia.Methods: Adults with diabetes were recruited from non-metropolitan Australian publicly-funded podiatry services. Theprimary variable of interest was the University of Texas diabetic foot risk classification designated to each participant atbaseline. Independent risk factors for diabetes-related foot morbidity were identified using multivariable analysis.Results: Eight-hundred and ninety-nine participants enrolled, 443 (49.3%) in Tasmania and 456 (50.7%) in Victoria.Mean age was 67 years (SD 12.7), 9.2% had type 1 diabetes, 506 (56.3%) were male, 498 (55.4%) had diabetes for longerthan 10 years and 550 (61.2%) either did not know the ideal HbA1c target or reported that it was ≥7.0. A majority hadperipheral neuropathy or worse foot morbidity (61.0%). Foot morbidity was associated with male sex (OR 2.42, 95% CI1.82–3.22), duration of diabetes > 20 years (OR 3.25, 95% CI 2.22–4.75), and Tasmanian residence (OR 3.38, 95% CI 2.35–4.86).Conclusions: A high proportion of the regional Australian clinical population with diabetes seen by the publiclyfunded podiatric services in this study were at high risk of future limb threatening foot morbidity, and participantsresiding in Northern Tasmania are more likely to have worse diabetes-related foot morbidity than those from regionalVictoria. Service models should be reviewed to ensure that diabetes-related foot services are appropriately developedand resourced to deliver interdisciplinary evidence-based care.

Item Type: Article
Authors/Creators:Perrin, BM and Allen, P and Gardner, MJ and Chappell, A and Phillips, B and Massey, C and Skinner, I and Skinner, TC
Keywords: podiatry, diabetes, models of care, diabetic foot, Australia, rural
Journal or Publication Title: Journal of Foot and Ankle Research
Publisher: BioMed Central Ltd.
ISSN: 1757-1146
DOI / ID Number: 10.1186/s13047-019-0366-6
Copyright Information:

Copyright 2019 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/

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