Online Program

Predictive Factors of Diabetic Foot Screening Rates in the United States

Monday, November 2, 2015 : 11:06 a.m. - 11:24 a.m.

Trisha Sando, DPT, CWS, MSc, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA
Steven A. Cohen, DrPH, MPH, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, Richmond, VA
In 2010, more than 20 million Americans carried the diagnosis of diabetes mellitus type 2 (DM2), a major public health concern.  The prevention of diabetic foot ulcers (DFU), a complication occurring in at least 25% of individuals, would benefit from increased public health interventions.  Complications of DFUs lead to lower extremity amputation and death.  Early identification of those at high risk for DFUs can prevent ulceration, reduce amputation rates and improve quality of life.  The National Diabetes Education Program recommends annual DM foot screening (DMFS), a procedure that requires minimal equipment and time and whose results are easily determined during a clinic visit.  DMFS rates are approximately 75% nationwide. Utilizing the 2013 Behavioral Risk Factors Surveillance Survey (BRFFS) data, we used multivariable logistic regression analysis to understand factors that influence DMFS rates controlling for confounders.  Results indicate having at least one HgbA1c test per year (AOR: 4.54, 95%CI-3.57-5.76), seeing a physician specifically for DM concerns (AOR: 3.35, 95%CI-2.86, 3.92), having insurance (AOR: 1.49, 95%CI-1.22, 1.83), having a primary care physician (AOR: 1.48, 95%CI-1.17, 1,88) and being black (AOR: 1.63, 95%CI-1.4, 1.9) were highly predictive of having an annual DMFS.  However, Hispanic Americans (AOR: 0.71, 95%CI-1.4-1.9) and those under age 65 (AOR: 0.84, 95%CI- 0.76, 0.94) were less likely to have undergone DMFS.  Based on these analytic findings, public health professionals can develop strategies to target the 25% of patients with DM2 that are not screened. Improving DMFS rates will increase prevention of DFUs and decrease the rates of amputations.

Learning Areas:

Chronic disease management and prevention
Clinical medicine applied in public health

Learning Objectives:
Describe demographic and clinical variables which influence rates of diabetic foot screening examinations. Define groups which may be a risk of not having an annual diabetic foot screening examination.

Keyword(s): Diabetes, Chronic Disease Management and Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted and completed the data analysis for this abstract while a PhD student at Virginia Commonwealth University. I utilized publicly available data and there was no additional funding beyond my graduate studentship stipend. Additionally, I have 9 years of clinical experience working with populations at risk for and with diabetic foot ulcers.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.