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Development and assessment of a simple scoring system for the risk of developing diabetic foot

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Abstract

Identification of risk factors for diabetic foot and creation of risk classifications based on these factors are important for prevention of diabetic foot. We have created a simple screening score system based on information obtained during routine medical checkups to identify patients at high risk of developing diabetic foot and examined the efficacy of this system. We compared 108 patients in the diabetic foot ulcer group with 108 age and sex-matched controls who were hospitalized at Saiseikai Central Hospital in Tokyo. The risk scores of 316 diabetic outpatients whose feet were examined from April 2011 to September 2012 were calculated. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the ability of the risk score to diagnose high-risk patients in categories ≥1 of the risk classification of the International Working Group on the Diabetic Foot (IWGDF). Differences between the ulcer and control groups were observed for 5 items: (1) diabetes duration, (2) average corrected bilateral visual acuity, (3) estimated glomerular filtration rate, (4) marital status, and (5) occupation. Multiple logistic analysis was performed using these items as independent variables, and the scoring system was created from the odds ratios. The scoring system cutoff value (≥7) was 56.9 % sensitive and 95.2 % specific for patients in IWGDF category ≥1 when applied in 316 outpatient foot examinations, and its ROC area under the curve was 0.865 (95 % CI, 0.83–0.91). High-risk diabetes patients were effectively identified by evaluating risk factors that included social characteristics and clinical examination findings.

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Acknowledgments

The study was not funded by a grant from any company. All procedures followed were in accordance with the ethical standards of the committee on human experimentation (institutional and national) and with the Declaration of Helsinki.

Conflict of interest

The authors state that they have no conflicts of interest. M. Tomita wrote the paper and analyzed the data. M. Okisugi, M Kawasaki, T. Katsuki, Y. Oikawa, and Y. Atsumi reviewed/edited the paper. Y. Kabeya and A. Shimada contributed to the discussion and reviewed/edited the paper.

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Authors and Affiliations

  1. Department of Internal Medicine, Tokyo Saiseikai Central Hospital, 1-4-17 Mita, Minato-ku, Tokyo, 108-0073, Japan

    Masuomi Tomita, Yusuke Kabeya, Mari Okisugi, Maki Kawasaki, Takeshi Katsuki, Yoichi Oikawa & Akira Shimada

  2. Diabetes Center, Eiju General Hospital, Tokyo, Japan

    Yoshihito Atsumi

Authors
  1. Masuomi Tomita
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  2. Yusuke Kabeya
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  3. Mari Okisugi
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  4. Maki Kawasaki
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  5. Takeshi Katsuki
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  6. Yoichi Oikawa
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  7. Akira Shimada
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  8. Yoshihito Atsumi
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Corresponding author

Correspondence to Masuomi Tomita.

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Tomita, M., Kabeya, Y., Okisugi, M. et al. Development and assessment of a simple scoring system for the risk of developing diabetic foot. Diabetol Int 6, 212–218 (2015). https://doi.org/10.1007/s13340-014-0189-4

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  • DOI: https://doi.org/10.1007/s13340-014-0189-4

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