Assessing the Prevalence of Foot Disease Among Diabetic Patients: Hogar Carlos María Ulloa, Costa Rica

The frequency of diabetes in Latin America is expected to increase by 38% over the next 10 years, compared with an estimated 14% increase in the total population. The total number of cases of diabetes in Latin America is expected to more than double and to exceed the number of cases in the US, Canada, and Europe by 2025. The position statement of the American Diabetes Association is that a comprehensive foot examination should be conducted at least annually and should assess skin, neurologic, vascular, and biomechanical status.

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Dr. Torres, the University of South Carolina’s Director of the Consortium for Latino Immigration Studies and professor of epidemiology, and I have collaborated with Dr. Edelio Pérez Domínguez, the primary care physician at Hogar Carlos María Ulloa (HCMU), a nursing home in San José, Costa Rica. Because he noticed an unusually high prevalence of foot complications amongst diabetic patients at the nursing home, we constructed a comprehensive foot health assessment physical examination form, which can be used to determine a patient’s risk of developing serious foot problems, such as hallux valgus, clubfoot, ulcers, and neuropathy.

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I then worked with several physical therapists at the nursing home in order to perform these foot examinations in order to assess the prevalence of foot disease. Dr. Torres and I then inputted this data collected from the evaluations into the Statistical Analysis Software in order to identify each patient’s risk of developing more serious foot complications. Of the 42 patients examined, 38.1% of patients had a low risk of developing serious foot pathology and 61.9% had a moderate risk in their left foot; 35.71% had a low risk and 64.29% had a moderate risk in their right foot. In fact, 1 of the patients had already developed a severe foot ulcer and one other had developed a pre-ulcerative lesion. This summer, we will collect additional data that will allow us to determine the factors associated with the increase in foot disease in order to construct an effective disease prevention plan for HCMU.