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Background <p>Diabetic foot syndrome (DFS) remains a major cause of morbidity and amputation in patients with type 2 diabetes mellitus (T2DM). Early risk identification is essential, yet real-world data on the application of the International Working Group on the Diabetic Foot (IWGDF) risk classification is limited.</p> Objective&#xa0; <p>This study aimed to determine the prevalence and predictors of DFS risk using the IWGDF criteria.</p> Methods <p>A cross-sectional study was conducted on 530 T2DM patients without active foot ulcers attending an outpatient diabetes clinic. Each participant underwent a comprehensive foot examination and was classified into four IWGDF risk categories. Demographic, clinical, and biochemical parameters were compared across risk groups using appropriate statistical tests.</p> Results <p>Among 530 participants (mean age: X ± SD; 55% female), 24.2% were classified as moderate risk and 20.8% as high risk, while 10% had an undiagnosed ulcer at the initial assessment. Higher risk categories were significantly associated with older age (<i>p</i> &lt; 0.001), longer diabetes duration (<i>p</i> &lt; 0.001), higher HbA1c (<i>p</i> = 0.012), and increased waist circumference (<i>p</i> &lt; 0.001). Renal dysfunction, including reduced GFR (<i>p</i> &lt; 0.001) and microalbuminuria (<i>p</i> &lt; 0.001), showed significant associations with increasing risk categories. The prevalence of peripheral neuropathy and peripheral artery disease progressively increased across risk levels (<i>p</i> &lt; 0.001 for both).</p> Conclusions <p>Nearly half of patients without clinical symptoms were at moderate-to-high DFS risk. Routine implementation of IWGDF-based screening in outpatient care can enable early identification of high-risk individuals, optimize preventive strategies, and potentially reduce ulceration and amputation rates.</p>

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Prevalence and risk factors of diabetic foot syndrome in type 2 diabetes: Clinical utility of the IWGDF risk classification

  • 期刊论文

  • 发表日期：

    2026年4月18日

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  • Seydahmet Akın,
  • Aysun Şeker,
  • Zeki Aydın,
  • Aysun Şenses Kürkçü,
  • Özcan Keskin

摘要

Background

Diabetic foot syndrome (DFS) remains a major cause of morbidity and amputation in patients with type 2 diabetes mellitus (T2DM). Early risk identification is essential, yet real-world data on the application of the International Working Group on the Diabetic Foot (IWGDF) risk classification is limited.

Objective 

This study aimed to determine the prevalence and predictors of DFS risk using the IWGDF criteria.

Methods

A cross-sectional study was conducted on 530 T2DM patients without active foot ulcers attending an outpatient diabetes clinic. Each participant underwent a comprehensive foot examination and was classified into four IWGDF risk categories. Demographic, clinical, and biochemical parameters were compared across risk groups using appropriate statistical tests.

Results

Among 530 participants (mean age: X ± SD; 55% female), 24.2% were classified as moderate risk and 20.8% as high risk, while 10% had an undiagnosed ulcer at the initial assessment. Higher risk categories were significantly associated with older age (p < 0.001), longer diabetes duration (p < 0.001), higher HbA1c (p = 0.012), and increased waist circumference (p < 0.001). Renal dysfunction, including reduced GFR (p < 0.001) and microalbuminuria (p < 0.001), showed significant associations with increasing risk categories. The prevalence of peripheral neuropathy and peripheral artery disease progressively increased across risk levels (p < 0.001 for both).

Conclusions

Nearly half of patients without clinical symptoms were at moderate-to-high DFS risk. Routine implementation of IWGDF-based screening in outpatient care can enable early identification of high-risk individuals, optimize preventive strategies, and potentially reduce ulceration and amputation rates.