Risk factors for diabetic at-risk foot disease among the diabetes over 60 years old: a cross-sectional study

Background Most studies related to at-risk foot are based on databases, cohorts, hospitalized patients, or outpatient studies, lacking comprehensive data on risk factors. According to the latest Diabetic foot risk stratification system, there is currently a lack of research or descriptions of the diabetic at-risk foot population. AIMs This study aims to investigate the prevalence, characteristics, and influencing factors of at-risk foot conditions in the diabetic population over 60 years old. Methods The study included 2003 diabetic patients from the Diabetic Foot Screening Project in Xiamen, China, from June 2022 to June 2023. Data were collected through questionnaires, physical examinations, and fasting blood glucose. All patients underwent screenings for three major categories: foot deformities, LOPS (Loss of Protective Sensation), and PAD (Peripheral Arterial Disease). Results The prevalence of at-risk foot conditions among diabetics over 60 years old was 33.50%. After adjusting for potential confounders, each 1 mmol/L increase in fasting blood glucose (FBG) was associated with a 4.8% increase in the probability of at-risk foot condition (OR = 1.048, 95% CI: 1.018–1.078, p = 0.001). Additionally, for every 1 dollar increase in income, the probability of at-risk foot condition increased by 37.4% (OR = 1.374, 95% CI: 1.022–1.848, p = 0.035). In contrast, the presence of hypertension reduced the probability of at-risk foot condition by 37.4% (OR = 0.626, 95% CI: 0.464–0.845, p = 0.002). Cardiovascular disease (CVD) significantly increased the probability of at-risk foot condition by approximately 90.6% (OR = 1.906, 95% CI: 1.091–3.328, p = 0.023). Cerebrovascular disease (CBD) significantly reduced the probability (OR = 0.226, 95% CI: 0.064–0.803, p = 0.022), while kidney disease (KD) significantly increased it by approximately 257.8% (OR = 3.578, 95% CI: 1.567–8.171, p = 0.025). Notably, peripheral neuropathy (PN) significantly increased the probability of at-risk foot condition by approximately 882.9% (OR = 9.829, 95% CI: 4.607–20.969, p 0.0001). Diabetic duration, retinopathy, and cataracts were not statistically significantly associated with the risk of at-risk foot conditions. Conclusion A high percentage of people with diabetes over 60 years old develop at-risk foot. Fasting blood glucose, income, hypertension, cardiovascular disease, cerebrovascular disease, kidney disease, and peripheral neuropathy are significant independent risk factors for at-risk foot conditions, while diabetic duration, retinopathy, and cataracts are not associated with the risk.