Prevalence and awareness of functional and structural foot abnormalities in children and adolescents with type 1 diabetes
-
A. Wever
,
B.G. Schickenberg-Werrij
Abstract
Background:
The ISPAD guideline 2011/2014 advises annual podiatric screening to detect foot complications and identify other possible risk factors such as functional and structural foot abnormalities. The aim of this study was to assess the prevalence and awareness of neurovascular, functional and structural foot abnormalities in children and adolescents with type 1 diabetes mellitus (T1DM).
Methods:
All patients aged 0–18 years with T1DM were invited for a foot examination and structured questionnaire by a certified podiatrist.
Results:
Three of the examined patients (n=128) showed signs of possible long-term complications. Structural and functional foot problems were observed in 71.9% (n=92). Of all patients, 38.3% (n=49) required further treatment by a podiatrist.
Conclusions:
Functional and structural foot abnormalities are a frequent problem in children with T1DM in the southern part of the Netherlands. These abnormalities are an additional risk factor for developing long-term foot complications. Education in and implementation of the guideline are necessary.
Acknowledgments
We acknowledge the following pediatricians: Mw M. van Helvoirt, Dhr. R. Thompson. Diabetes nurse specialists: Mw G. Berben, Mw T. op den Camp, Mw W. Geraart, Mw. C. Gullikers, Mw Haagmans, Dhr J. Hanekom, Dhr J. Kölker, Dhr N. Peeters, Dhr P. Ribbink and Mw G. Smeets. Podiatrists: Boris Aerts, M. Bruekers, R. vd Boomen, A. Colapinto, K. Huskens, S. Iser, I. Kanters, C. Lafeber, L. Rijswijk, K. Scheurs, E. Schmitz, M. Steenbakkers, F. Theelen, R. Thijsssen, N. Tonnaer and J. Willems. Statistic analyses: R. Senden.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Rasli MH, Zacharin MR. Foot problems and effectiveness of foot care education in children and adolescents with diabetes mellitus. Pediatr Diabetes 2008;9:602–8.10.1111/j.1399-5448.2008.00432.xSearch in Google Scholar PubMed
2. Boulton AJ, Armstrong DG, Albert SF, Frykberg RG, Hellman R, et al. Comprehensive foot examination and risk assessment: a report of the task force of the foot care interest group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists. Diabetes Care 2008;31:1679–85.10.1093/ptj/88.11.1436Search in Google Scholar PubMed
3. Cho YH, Craig ME, Hing S, Gallego PH, Poon M, et al. Microvascular complications assessment in adolescents with 2- to 5-yr duration of type 1 diabetes from 1990 to 2006. Pediatr Diabetes 2011;12:682–9.10.1111/j.1399-5448.2011.00762.xSearch in Google Scholar PubMed
4. Lee SS, Han HS, Kim H. A 5-yr follow-up nerve conduction study for the detection of subclinical diabetic neuropathy in children with newly diagnosed insulin-dependent diabetes mellitus. Pediatr Diabetes 2010;11:521–8.10.1111/j.1399-5448.2009.00636.xSearch in Google Scholar PubMed
5. Nelson D, Mah JK, Adams C, Hui S, Crawford S, et al. Comparison of conventional and non-invasive techniques for the early identification of diabetic neuropathy in children and adolescents with type 1 diabetes. Pediatr Diabetes 2006;7:305–10.10.1111/j.1399-5448.2006.00208.xSearch in Google Scholar PubMed
6. Abad F, Diaz-Gomez NM, Rodriguez I, Perez R, Delgado JA. Subclinical pain and thermal sensory dysfunction in children and adolescents with Type 1 diabetes mellitus. Diabet Med 2002;19:827–31.10.1046/j.1464-5491.2002.00793.xSearch in Google Scholar PubMed
7. Hyllienmark L, Brismar T, Ludvigsson J. Subclinical nerve dysfunction in children and adolescents with IDDM. Diabetologia 1995;38:685–92.10.1007/BF00401840Search in Google Scholar PubMed
8. Trotta D, Verrotti A, Salladini C, Chiarelli F. Diabetic neuropathy in children and adolescents. Pediatr Diabetes 2004;5:44–57.10.1111/j.1399-543X.2004.00041.xSearch in Google Scholar PubMed
9. Nordwall M, Hyllienmark L, Ludvigsson J. Early diabetic complications in a population of young patients with type 1 diabetes mellitus despite intensive treatment. J. Pediatr Endocrinol Metab 2006;19:45–54.10.1515/JPEM.2006.19.1.45Search in Google Scholar PubMed
10. Reiber GE, Vileikyte L, Boyko EJ, del Aguila M, Smith DG, et al. Causal pathways for incident lower-extremity ulcers in patients with diabetes from two settings. Diabetes Care 1999;22:157–62.10.2337/diacare.22.1.157Search in Google Scholar PubMed
11. Barnett SJ, Shield JP, Potter MJ, Baum JD. Foot pathology in insulin dependent diabetes. Arch Dis Child 1995;73:151–3.10.1136/adc.73.2.151Search in Google Scholar PubMed PubMed Central
12. IDF/ISPAD. The Global IDF/ISPAD Guideline for Diabetes in Childhood and Adolescence. Pediatr Diabetes 2011.Search in Google Scholar
13. ISPAD/NDF. Richtlijn voor de behandeling van kinderen en tieners met diabetes, 2003.Search in Google Scholar
14. Vereniging NI. Richtlijn Diabetesische Voet. 2007.Search in Google Scholar
15. Putten M. van MMv. Voetscreeningsprotocol. Utrecht, The Netherlands: EKDV.Search in Google Scholar
16. Rutten GE, De Grauw WJ, Nijpels G, Goudswaard AN, Uitewaal PJ, et al. NHG-Standaard Diabetes Mellitus type 2. Huisarts en Wetenschap 2006;49:137–52.Search in Google Scholar
17. Nery Ferreira BE, Silva IN, de Oliveira JT. High prevalence of diabetic polyneuropathy in a group of Brazilian children with type 1 diabetes mellitus. J Pediatr Endocrinol Metab 2005;18:1087–94.10.1515/JPEM.2005.18.11.1087Search in Google Scholar
18. Krul M, van der Wouden JC, Schellevis FG, van Suijlekom-Smit LW, Koes BW. Foot problems in children presented to the family physician: a comparison between 1987 and 2001. Fam Pract 2009;26:174–9.10.1093/fampra/cmp018Search in Google Scholar PubMed
19. G. W. Children’s feet, a practical foot care guide for parents, teachers and children. London, UK: The Society of Chiropodists and Podiatrists, 2006.Search in Google Scholar
20. Kapellen TM, Galler A, Kiess W. Higher frequency of paronychia (nail bed infections) in pediatric and adolescent patients with type 1 diabetes mellitus than in non-diabetic peers. J Pediatr Endocrinol Metab 2003;16:751–8.10.1515/JPEM.2003.16.5.751Search in Google Scholar
©2016 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Review
- A germline mutation of HRPT2/CDC73 (70 G>T) in an adolescent female with parathyroid carcinoma: first case report and a review of the literature
- Original Articles
- Seroprotection status of hepatitis B and measles vaccines in children with type 1 diabetes mellitus
- Prevalence and awareness of functional and structural foot abnormalities in children and adolescents with type 1 diabetes
- WHO European Childhood Obesity Surveillance Initiative in Serbia: a prevalence of overweight and obesity among 6–9-year-old school children
- Pilot study of newborn screening of inborn error of metabolism using tandem mass spectrometry in Malaysia: outcome and challenges
- In children with autoimmune thyroid diseases the association with Down syndrome can modify the clustering of extra-thyroidal autoimmune disorders
- Identification of monogenic gene mutations in Japanese subjects diagnosed with type 1B diabetes between >5 and 15.1 years of age
- Referral pattern of children with short stature to a pediatric endocrine clinic in Kuwait
- Factors associated with post-menarcheal growth: results of a longitudinal study in Chilean girls from different socioeconomic statuses
- Percentiles for anthropometric measures in Iranian children and adolescents: the CASPIAN-IV study
- Hormone disorder and vitamin deficiency in attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs)
- Case Reports
- Hyperinsulinism-hyperammonemia syndrome: a de novo mutation of the GLUD1 gene in twins and a review of the literature
- Novel homozygous likely-pathogenic intronic variant in INS causing permanent neonatal diabetes in siblings
- A girl with permanent neonatal diabetes due to KCNJ11 mutation presented with Mauriac syndrome after improper adjustment in sulfonylurea dosage over 6 years
- Treatment experience and long-term follow-up data in two severe neonatal hyperparathyroidism cases
- A novel splice site mutation of FGD1 gene in an Aarskog-Scott syndrome patient with a large anterior fontanel
