Advanced Glycation End-products and Foot Ulceration in Type 2 Diabetic Patients: A Case Control Study

A case-control study was conducted to determine association between foot ulcerations and advanced glycation endproducts (AGEs) among 1782 diabetic patients (type 1=124; type 2=1658) in Faisalabad, Pakistan. Active foot ulcers were identified in 3.75% of the patients. Sixty-seven patients with foot ulcers (49 males, 18 females) and 1715 patients without foot ulcers (854 males, 861 females) were evaluated for various clinical factors probably associated with foot ulcers. Diabetic patients with foot ulcers had longer duration of diabetes, poor glycaemic control and elevated plasma AGEs than patients without foot ulcers. There were no differences in renal, visual impairment, peripheral neuropathy and peripheral vascular disease between both groups. Patients with foot ulcers had plantar calluses, hallux valgus deformity and discolored nails. Multivariate analysis indicated that major independent risk factors of developing foot ulcers were duration of diabetes, peripheral neuropathy and glycaemic control but not AGEs levels. Despite its limitations, this study showed that diabetic foot ulcer is a multi-organ complication and emphasizes need for lifelong surveillance of the diabetic foot. © 2010 Friends Science Publishers