Regression coefficient (b) RESULTS AND DISCUSSION A Case Control Study of Diabetic Foot Ulcer in Kelantan Ninin Sukminingrum*, Sam’an M. Masudi*, Ab Azis Al Safi Ismail** *School of Dental Sciences, Universiti Sains Malaysia **School of Medical Sciences, Universiti Sains Malaysia ABSTRACT Table 2: Diabetes Mellitus Profile Data Variable Case (n=72) Control (n=216) Mean (SD) Freq. (%) DM type   Type I 2 (2.8) 3 (1.4) Type II 70 (97.2) 213 (98.6) DM duration 12.8 (6.38) 13.1 (7.73) Treatment type Mixed 19 (26.4) 13 (6.0) Insulin 21 (29.2) 73 (33.8) History of foot ulcer No 6 (8.3) 215 (99.5) Yes 66 (91.7) 1 (0.5) History of amputation 47 (65.3) 216 (100.0) 25 (34.7%) Current foot ulcer 1 (1.4%) 214 (99.1) 71 (98.6%) 2 (0.9) Latest HbA1c <7 18 (25.0) 104 (48.1) >7 54 (75.0) 112 (51.9) Objectives: The aim of this study was to describe the characteristics of diabetic foot ulcer patients in Kelantan and determine its associated factors. Methods: This is a retrospective study and case control study. The case are Diabetic patients with foot ulcer and the control are Diabetic patients with no foot ulcer. Data were obtain from record list of diabetic patient with foot ulcer and without foot ulcer who were attended to HUSM from 2009 to 2011. Identified records from record office database were screen for inclusion and exclusion criteria. Systematic random sampling was applied for each group. A total of 288 sample from 72 as a case DM with foot ulcer and 216 as a control of DM. Data entry and statistical analysis using PASW version 20.0. This study was approved by Human Ethic Committee of Universiti Sains Malaysia. Results: Diabetic Foot Ulcer (DFU) case mostly found in male, Malay, jobless, have duration of DM for more than 12 years, on Oral Anti Diabetic (OAD), usually have history of DFU or amputation, neuropathy complication, also orther complication of retinopathy. Data also shown that Coronary Heart Disease (CHD) and Cerebro Vascular Disease (CVD) complications are less in DFU. Conclusion: Prevention of DFU need proper treatment, target HbA1c less than 7 and foot care to avoid patients from neuropathy, foot ulcer and amputation. criteria. Systematic random sampling was applied for each group. A total of 288 sample from 72 as a case DM with foot ulcer and 216 as a control of DM. Data entry and statistical analysis using PASW version 20.0. Descriptive Statistic was used to determine the characteristic of variables which are numerical , in mean (SD) and categorical, in n (%). Multiple logistic regression analysis was used to evaluate factors associated with diabetic foot ulcer. This study was approved by Human Ethic Committee of Universiti Sains Malaysia. INTRODUCTION   Diabetes Mellitus is global health burden. It is estimated that 346 million people have diabetes worldwide (WHO, 2011). In Malaysia, the prevalence of diabetes keeps increasing from 6.3% (NHMS I, 1986) to 8.3% (NHMS II, 1996) then 11.6% (NHMS III, 2006). A total of 11.7% Kelantan population has diabetes (NHMS III, 2006). Foot ulcer is one of the common complications arise from diabetes mellitus. In a population based study in Norway, foot ulcers among diabetes is 10.4% (Iversen et al, 2008). It is reported that the prevalence of foot ulcers among diabetic patient in Malaysia is 9.5% (Rabia, 2007). Altered foot sensation, foot deformities, and previous foot ulcer or amputation of the other foot are strong predictors for foot ulceration (altered sensation: RR 2.2, 95% CI 1.5 to 3.1; foot deformity; RR 3.5, 95% CI 1.2 to 9.9; previous foot ulcer: RR1.6, 95% CI 1.2 to 2.3; previous amputation: RR 2.8, 95% CI 1.8 to 4.3 (Boyko, 1999). Table 3: History Foot ulcer or amputation on DFU Variables Regression coefficient (b) Adjusted OR (95% CI of OR) LR statistic (df) P value History of amputation   No 1 Yes 2.58 13.22 (3.156, 55.413) 12.47 (1) <0.001 size <3cm >3cm 2.75 15.56 (2.969, 81.862) 10.50 (1) 0.001 Color 2.48 11.93 (1.611, 88.300) 5.89 (1) 0.015 RESULTS AND DISCUSSION Table 1: Sociodemography Variable Case (n=72) Control (n=216) Mean (SD) Frequency (%) Age 62.1 (10.10)   65.3 (10.79) Gender Male 40 (55.6) 105 (48.6) Female 32 (44.4) 111 (51.4) Race Malay 68 (93.4) 201 (93.1) Others 4 (6.6) 15 (6.9) Occupation Government 3 (4.2) 37 (17.1) Self employment 15 (20.8) 36 (16.7) Executive 1 (0.5) Not working 54 (75.0) 142(65.7) Smoking status Non smoker 7 (9.7) 133 (61.6) Ex smoker 43 (59.7) 45 (20.8) Current smoker 22 (10.2) Unknown 19 (26.4) 16 (7.4) Table 4: Diabetes Mellitus Complications on DFU Variable Case (n=72) Control (n=216) Mean (SD) Frequency (%) Coronary Heart Disease   No 46 (63.9) 81 (37.5) Yes 26 (36.1) 135 (62.5) Cerebro-Vascular Disease 57 (79.2) 192 (88.9) 15 (20.8) 24 (11.1) Retinopathy 39 (54.2) 134 (62.0) 33 (45.8) 82 (38.0) Nephropathy 34 (47.2) 133 (61.6) 38 (52.8) 83 (38.4) Neuropathy 3 (4.2) 198 (91.7) 69 (95.8) 18 (8.3) Amputation status Case (n =72) Control (n =216) No amputated 43 (59.72%) 213 (98.6%) Amputated 29 (40.28%) 3 (1.4%) PURPOSE The aim of this study was to describe the characteristics of diabetic foot ulcer patients in Kelantan and the data could be used for prevention purposes. MATERIALS AND METHODS Diabetic Foot Ulcer (DFU) case in Kelantan mostly found in male, Malay, jobless, have duration of DM for more than 12 years, on Oral Anti Diabetic (OAD), usually have history of DFU or amputation, neuropathy complication, also orther complication of retinopathy and nephropathy. Data also shown that Coronary Heart Disease (CHD) and Cerebro Vascular Disease (CVD) complications are less in DFU patients. This is a retrospective study and case control study. The case are Diabetic patients with foot ulcer and the control are Diabetic patients with no foot ulcer. Data were obtain from record list of diabetic patient with foot ulcer and without foot ulcer who were attended to HUSM from 2009 to 2011. Identified records from record office database were screen for inclusion and exclusion CONCLUSION Prevention of DFU need proper treatment, target HbA1c less than 7 and foot care to avoid patients from neuropathy, foot ulcer and amputation.