Patient characteristics
| Subject population . | Standard therapy . | Enhanced therapy . | Structured foot examination . |
|---|---|---|---|
| n | 58 | 59 | 56 |
| Age (years) | 65.0 ± 9.6 (41–80) | 65.4 ± 9.3 (42–80) | 64.2 ± 8.6 (40–80) |
| Sex (% male) | 53.4 | 55.9 | 51.7 |
| Race | |||
| Non-Hispanic white | 31 (53.4) | 32 (54.2) | 31 (55) |
| Mexican American | 24 (41.4) | 22 (37.3) | 25 (45) |
| African American | 3 (5.2) | 3 (5.1) | 2 (4) |
| Type 2 diabetes | 56 (97) | 55 (93) | 53 (95) |
| Duration of diabetes (years) | 13.7 ± 10.3 (2–22) | 12.7 ± 9.7 (4–25) | 13.8 ± 11.5 (5–31) |
| Diabetes medication | |||
| Oral | 31 (53.4) | 32 (54.2) | 30 (53.6) |
| Insulin | 13 (22.4) | 15 (25.4) | 10 (17.9) |
| Combination | 10 (17.2) | 11 (18.6) | 12 (21.4) |
| Diet | 4 (6.9) | 1 (1.7) | 4 (7.1) |
| Ulcer history and locations | |||
| Hallux | 7 (12.1) | 4 (6.8) | 8 (14.3) |
| Toes | 29 (50.0) | 35 (59.4) | 30 (53.5) |
| Submetatarsal | 21 (36.2) | 17 (28.8) | 21 (37.5) |
| Midfoot to heel | 3 (5.1) | 7 (11.9) | 5 (8.9) |
| Patients with a history of previous amputation | 18 (31.0) | 13 (22.0) | 14 (25.0) |
| Amputation sites | |||
| Toe | 12 (20.7) | 11 (18.6) | 12 (21.4) |
| Toe and metatarsal | 8 (13.8) | 4 (6.8) | 4 (7.1) |
| Midfoot | 0 | 2 (3.4) | 2 (3.6) |
| History of vascular surgery | |||
| Lower extremity bypass | 3 (5.2) | 0 | 0 |
| Lower extremity angioplasty | 0 | 0 | 1 (1.8) |
| Coronary artery bypass surgery | 2 (3.4) | 1 (1.7) | 0 |
| Cardiac angioplasty | 0 | 0 | 2 (3.6) |
| Lower extremity examination | |||
| Neuropathy evaluation | |||
| Semmes-Weinstein 10-g monofilament right | 5.2 ± 4.8 | 5.3 ± 4.7 | 5.2 ± 4.7 |
| Semmes-Weinstein 10-g monofilament left | 4.7 ± 4.3 | 4.7 ± 4.3 | 4.7 ± 4.3 |
| Vibration perception threshold right | 41.8 ± 9.8 (14–50) | 40.6 ± 9.6 (12–50) | 40.6 ± 8.6 (14–50) |
| Vibration perception threshold left | 39.3 ± 8.6 (12–50) | 38.6 ± 8.1 (11–50) | 39.0 ± 8.0 (12–50) |
| Foot deformity | |||
| Hallux rigidus | 50 (86.2) | 51 (86.4) | 46 (82.1) |
| Hallux valgus | 23 (39.0) | 33 (55.0) | 12 (21.0) |
| Claw toe/hammer toe | 33 (56.0) | 41 (69.0) | 41 (73.0) |
| Vascular examination | |||
| Ankle-brachial index right | 1.1 ± 0.4 (0.7–1.5) | 1.1 ± 0.4 (0.7–1.5) | 1.1 ± 0.6 (0.8–2.0) |
| Ankle-brachial index left | 1.2 ± 0.5 (0.7–1.7) | 1.1 ± 0.6 (0.7–1.9) | 1.2 ± 0.6 (0.7–1.9) |
| Activity (steps per day) | 3,817 ± 3,364 | 3,489 ± 2,706 | 3,963 ± 2,363 |
| Footwear compliance | |||
| Time prescribed shoes were worn (h) | |||
| <4 | 1 (1.7) | 2 (3.4) | 0 |
| 4–8 | 5 (8.6) | 8 (13.6) | 15 (26.8) |
| >8–12 | 33 (56.9) | 31 (52.5) | 19 (33.9) |
| >12 | 19 (32.6) | 18 (30.5) | 22 (39.3) |
| Subject population . | Standard therapy . | Enhanced therapy . | Structured foot examination . |
|---|---|---|---|
| n | 58 | 59 | 56 |
| Age (years) | 65.0 ± 9.6 (41–80) | 65.4 ± 9.3 (42–80) | 64.2 ± 8.6 (40–80) |
| Sex (% male) | 53.4 | 55.9 | 51.7 |
| Race | |||
| Non-Hispanic white | 31 (53.4) | 32 (54.2) | 31 (55) |
| Mexican American | 24 (41.4) | 22 (37.3) | 25 (45) |
| African American | 3 (5.2) | 3 (5.1) | 2 (4) |
| Type 2 diabetes | 56 (97) | 55 (93) | 53 (95) |
| Duration of diabetes (years) | 13.7 ± 10.3 (2–22) | 12.7 ± 9.7 (4–25) | 13.8 ± 11.5 (5–31) |
| Diabetes medication | |||
| Oral | 31 (53.4) | 32 (54.2) | 30 (53.6) |
| Insulin | 13 (22.4) | 15 (25.4) | 10 (17.9) |
| Combination | 10 (17.2) | 11 (18.6) | 12 (21.4) |
| Diet | 4 (6.9) | 1 (1.7) | 4 (7.1) |
| Ulcer history and locations | |||
| Hallux | 7 (12.1) | 4 (6.8) | 8 (14.3) |
| Toes | 29 (50.0) | 35 (59.4) | 30 (53.5) |
| Submetatarsal | 21 (36.2) | 17 (28.8) | 21 (37.5) |
| Midfoot to heel | 3 (5.1) | 7 (11.9) | 5 (8.9) |
| Patients with a history of previous amputation | 18 (31.0) | 13 (22.0) | 14 (25.0) |
| Amputation sites | |||
| Toe | 12 (20.7) | 11 (18.6) | 12 (21.4) |
| Toe and metatarsal | 8 (13.8) | 4 (6.8) | 4 (7.1) |
| Midfoot | 0 | 2 (3.4) | 2 (3.6) |
| History of vascular surgery | |||
| Lower extremity bypass | 3 (5.2) | 0 | 0 |
| Lower extremity angioplasty | 0 | 0 | 1 (1.8) |
| Coronary artery bypass surgery | 2 (3.4) | 1 (1.7) | 0 |
| Cardiac angioplasty | 0 | 0 | 2 (3.6) |
| Lower extremity examination | |||
| Neuropathy evaluation | |||
| Semmes-Weinstein 10-g monofilament right | 5.2 ± 4.8 | 5.3 ± 4.7 | 5.2 ± 4.7 |
| Semmes-Weinstein 10-g monofilament left | 4.7 ± 4.3 | 4.7 ± 4.3 | 4.7 ± 4.3 |
| Vibration perception threshold right | 41.8 ± 9.8 (14–50) | 40.6 ± 9.6 (12–50) | 40.6 ± 8.6 (14–50) |
| Vibration perception threshold left | 39.3 ± 8.6 (12–50) | 38.6 ± 8.1 (11–50) | 39.0 ± 8.0 (12–50) |
| Foot deformity | |||
| Hallux rigidus | 50 (86.2) | 51 (86.4) | 46 (82.1) |
| Hallux valgus | 23 (39.0) | 33 (55.0) | 12 (21.0) |
| Claw toe/hammer toe | 33 (56.0) | 41 (69.0) | 41 (73.0) |
| Vascular examination | |||
| Ankle-brachial index right | 1.1 ± 0.4 (0.7–1.5) | 1.1 ± 0.4 (0.7–1.5) | 1.1 ± 0.6 (0.8–2.0) |
| Ankle-brachial index left | 1.2 ± 0.5 (0.7–1.7) | 1.1 ± 0.6 (0.7–1.9) | 1.2 ± 0.6 (0.7–1.9) |
| Activity (steps per day) | 3,817 ± 3,364 | 3,489 ± 2,706 | 3,963 ± 2,363 |
| Footwear compliance | |||
| Time prescribed shoes were worn (h) | |||
| <4 | 1 (1.7) | 2 (3.4) | 0 |
| 4–8 | 5 (8.6) | 8 (13.6) | 15 (26.8) |
| >8–12 | 33 (56.9) | 31 (52.5) | 19 (33.9) |
| >12 | 19 (32.6) | 18 (30.5) | 22 (39.3) |
Data are means ± SD (range) or n (%).