Endocrine Abstracts

Aims: Charcot foot (CF) is a rare complication of T2DM, progressively leads to bone deformities of the lower extremities. The aim of this study was to record baseline characteristics of patients with CF.

Patients and methods: A multicenter retrospective cohort study (n=774), including all patients diagnosed with CF from eight Diabetic Foot Clinics in 6 countries between 01/01/1996 and 31/12/2022, was performed. Data regarding duration and complications of DM, anthropometric, clinical and laboratory parameters were obtained from the medical records.

Results: Mean age of patients was 56.5±10.7 years and the mean age at CF diagnosis was 54.5±11.7 years, 70.5% were men. T2DM was more prevalent (83.2%), the mean duration of DM at diagnosis was 17.3 years and median glycated hemoglobin was 8% (Interquartile range-IQR 6.8-9.3%) at diagnosis of CF. Regarding anthropometric features, mean height, weight and body mass index (BMI) were 169.40±16.5 cm, 84.4±21.0 kg, 28.97±7.8 kg/m², respectively. Most of the patients had hypertension (74.5%), quarter of them were active or ex-smokers (25.2%) or alcohol users (23.3) and previous medical history comprised of peripheral artery disease (19.7%), coronary artery disease (17.5%) or stroke (5.4%). Neuropathy was the most prevalent (89%) amongst the microvascular complications followed by retinopathy (60%) and nephropathy (45%). A foot ulcer was present in about half of the patients (48.5%) while CF was equally distributed between feet (right foot 49%-left foot 44%-bilateral 6.5%) and majority of them were in midfoot (65%), forefoot 18%, hindfoot 13.9% and multiple joint involvement (2.6%). Patients with type 1DM in comparison with those with T2DM were diagnosed with CF at younger age (46.9±11.0 vs 57.9±10.2 years, P<0.001), had lower BMI (26.6±6.0 vs 29.5±8.0 kg/m², P=0.001) and longer diabetes duration [median (IQ): 29.0 (21.0-38.0) vs 14.0 (8.0-20.0) years, P<0.001]. No differences were found between T1D and T2DM in HbA1c. No significant gender differences were found in terms of age at CF diagnosis, BMI or HbA1c; however, the duration of DM at CF diagnosis was lower in men vs women 15.0 (1.0-22.0) vs 17.0 (10.0-25.0) years, P=0.037].

Conclusion: This is the largest cohort of patients with CF globally. CF is predominant in males, occurs in people with long-standing DM, is often accompanied by microvascular complications, half of patients have foot ulcers at CF diagnosis, affects equally both feet, and the more frequent location is in the midfoot. Further studies are needed to look at outcomes and mortality.