Foot abnormalities in Canadian Aboriginal adolescents with Type 2 diabetes

AIMS: To determine the profile of foot abnormalities in Canadian Aboriginal adolescents with Type 2 diabetes and the risk factors associated with these abnormalities. METHODS: Aboriginal adolescents with Type 2 diabetes underwent an interview, medical record review and foot examination in a tertiary care, paediatric hospital diabetes clinic and two geographically remote outreach clinics. The notes of 110 subjects were reviewed [mean age 15 +/- 3 years; mean duration of diabetes, 30 +/- 20 months; 71 (66%) female and 39 (34%) male] and 77 (70%) of the subjects were examined. RESULTS: Foot abnormalities were identified by either interview or notes review, and included poor toenail condition in 85 (77%), paronychia in 29 (26%), ingrowing toenails in 16 (15%) and neuropathic symptoms in 13 (12%) subjects. Foot abnormalities were identified by examination in many subjects, including poor toenail condition in 38 (49%), calluses in 34 (44%) and paronychia in 13 (17%) subjects. Eighteen (24%) of 75 subjects did not have running water in the home. Factors that significantly increased the presence of foot abnormalities included: foot care provided by a person other than self; absence of running water in the home; decreased frequency of bathing; and decreased frequency of nail clipping. A greater percentage of subjects living on a reservation or rural community had specialized consultations for retinal examination, footwear, or both than of those living in an urban or unknown residence. CONCLUSIONS: A high prevalence of foot abnormalities was noted in Aboriginal adolescents with Type 2 diabetes. These findings highlight the associated comorbidities in this population, emphasizing the need for early detection and intervention.