J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Original Article

Volume 13, Number 12, December 2021, pages 521-529

Do Outpatient Podiatry Evaluations Reduce the Risk of Falls in Elderly Patients With Diabetes Mellitus?

**Table 1.** Baseline Characteristics Based on Podiatry Evaluation Status
Variable	PODEVAL(N = 92)	No PODEVAL (N = 105)	P
PODEVAL: Had an evaluation by a podiatrist; No PODEVAL: Did not have a podiatrist evaluation; SD: standard deviation; CAD: coronary artery disease; CVA: cerebrovascular accident; PAD: peripheral artery disease; CAS: carotid artery stenosis; CHF: congestive heart failure; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; SBP: systolic blood pressure; DBP: diastolic blood pressure; BPM: beats per minute; BMI: body mass index; HbA1c: glycosylated hemoglobin; OHA: oral hypoglycemic agent; ACE-I: angiotensin-converting enzyme inhibitor; ARB: angiotensin II receptor blocker.
Age mean (SD)	76.9 (6.9)	75.5 (6.9)	0.151
Gender
Male (n, %)	51 (55.4)	43 (41.0)	0.042
Female (n, %)	41 (44.6)	62 (59.0)
Race
Caucasian (n, %)	58 (63.0)	68 (64.8)	0.682
African-American (n, %)	19 (20.7)	17 (16.2)
Other (n, %)	15 (16.3)	20 (19.0)
Social factors
Cigarettes (n, %)	18 (19.6)	20 (19.0)	0.927
Alcohol (n, %)	29 (31.5)	34 (32.4)	0.897
Comorbidities
CAD (n, %)	52 (56.5)	47 (44.8)	0.100
CVA (n, %)	11 (12.0)	10 (9.5)	0.581
PAD (n, %)	46 (50.0)	28 (26.7)	< 0.001
Dementia (n, %)	17 (18.5)	18 (17.1)	0.598
Osteoarthritis (n, %)	58 (63.0)	77 (73.1)	0.121
CAS (n, %)	17 (18.5)	12 (11.4)	0.164
CHF (n, %)	20 (21.7)	14 (13.3)	0.119
Dizziness (n, %)	33 (35.9)	42 (40.0)	0.551
Anemia (n, %)	44 (47.8)	54 (51.4)	0.614
CKD (n, %)	53 (57.6)	60 (57.1)	0.947
COPD (n, %)	19 (20.7)	22 (21.0)	0.959
Syncope (n, %)	13 (14.1)	16 (15.2)	0.827
Peripheral neuropathy (n, %)	69 (75.0)	50 (47.6)	< 0.001
Bunions and callouses (n, %)	45 (48.9)	29 (27.6)	0.002
Hammertoe (n, %)	23 (25.0)	16 (15.2)	0.086
Vitals
SBP (mm Hg), mean (SD)	128 (12.6)	131 (13.7)	0.178
DBP (mm Hg), mean (SD)	72 (10.4)	75 (9.4)	0.077
Pulse (BPM), mean (SD)	74 (11.2)	76 (12.2)	0.213
Other parameters
BMI, mean (SD)	30.3 (5.9)	31.7 (7.5)	0.145
HbA1c, mean (SD)	7.3 (1.2)	6.9 (1.1)	0.038
Vitamin D (ng/mL), mean (SD)	34.1 (17.2)	34.5 (12.9)	0.861
Vitamin B₁₂ (µg/mL), mean (SD)	860.8 (695.3)	856.8 (706.6)	0.974
Medication
Statin (n, %)	76 (82.6)	84 (80.0)	0.640
Aspirin (n, %)	61 (66.3)	62 (59.0)	0.294
Insulin (n, %)	32 (34.8)	18 (18.1)	0.008
OHA (n, %)	68 (73.9)	84 (80.0)	0.310
ACE-I (n, %)	25 (27.2)	25 (23.8)	0.588
ARB (n, %)	31 (33.7)	49 (46.7)	0.064
Outcome
Fall (n, %)	33 (35.9)	34 (32.4)	0.606

Table 1. Baseline Characteristics Based on Podiatry Evaluation Status

Variable

PODEVAL(N = 92)

No PODEVAL (N = 105)

PODEVAL: Had an evaluation by a podiatrist; No PODEVAL: Did not have a podiatrist evaluation; SD: standard deviation; CAD: coronary artery disease; CVA: cerebrovascular accident; PAD: peripheral artery disease; CAS: carotid artery stenosis; CHF: congestive heart failure; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; SBP: systolic blood pressure; DBP: diastolic blood pressure; BPM: beats per minute; BMI: body mass index; HbA1c: glycosylated hemoglobin; OHA: oral hypoglycemic agent; ACE-I: angiotensin-converting enzyme inhibitor; ARB: angiotensin II receptor blocker.

Age mean (SD)

76.9 (6.9)

75.5 (6.9)

0.151

Gender

Male (n, %)

51 (55.4)

43 (41.0)

0.042

Female (n, %)

41 (44.6)

62 (59.0)

Race

Caucasian (n, %)

58 (63.0)

68 (64.8)

0.682

African-American (n, %)

19 (20.7)

17 (16.2)

Other (n, %)

15 (16.3)

20 (19.0)

Social factors

Cigarettes (n, %)

18 (19.6)

20 (19.0)

0.927

Alcohol (n, %)

29 (31.5)

34 (32.4)

0.897

Comorbidities

CAD (n, %)

52 (56.5)

47 (44.8)

0.100

CVA (n, %)

11 (12.0)

10 (9.5)

0.581

PAD (n, %)

46 (50.0)

28 (26.7)

< 0.001

Dementia (n, %)

17 (18.5)

18 (17.1)

0.598

Osteoarthritis (n, %)

58 (63.0)

77 (73.1)

0.121

CAS (n, %)

17 (18.5)

12 (11.4)

0.164

CHF (n, %)

20 (21.7)

14 (13.3)

0.119

Dizziness (n, %)

33 (35.9)

42 (40.0)

0.551

Anemia (n, %)

44 (47.8)

54 (51.4)

0.614

CKD (n, %)

53 (57.6)

60 (57.1)

0.947

COPD (n, %)

19 (20.7)

22 (21.0)

0.959

Syncope (n, %)

13 (14.1)

16 (15.2)

0.827

Peripheral neuropathy (n, %)

69 (75.0)

50 (47.6)

< 0.001

Bunions and callouses (n, %)

45 (48.9)

29 (27.6)

0.002

Hammertoe (n, %)

23 (25.0)

16 (15.2)

0.086

Vitals

SBP (mm Hg), mean (SD)

128 (12.6)

131 (13.7)

0.178

DBP (mm Hg), mean (SD)

72 (10.4)

75 (9.4)

0.077

Pulse (BPM), mean (SD)

74 (11.2)

76 (12.2)

0.213

Other parameters

BMI, mean (SD)

30.3 (5.9)

31.7 (7.5)

0.145

HbA1c, mean (SD)

7.3 (1.2)

6.9 (1.1)

0.038

Vitamin D (ng/mL), mean (SD)

34.1 (17.2)

34.5 (12.9)

0.861

Vitamin B₁₂ (µg/mL), mean (SD)

860.8 (695.3)

856.8 (706.6)

0.974

Medication

Statin (n, %)

76 (82.6)

84 (80.0)

0.640

Aspirin (n, %)

61 (66.3)

62 (59.0)

0.294

Insulin (n, %)

32 (34.8)

18 (18.1)

0.008

OHA (n, %)

68 (73.9)

84 (80.0)

0.310

ACE-I (n, %)

25 (27.2)

25 (23.8)

0.588

ARB (n, %)

31 (33.7)

49 (46.7)

0.064

Outcome

Fall (n, %)

33 (35.9)

34 (32.4)

0.606

**Table 2.** Baseline Characteristics Based on the Status of Falls
Variable	Fall (N = 67)	No fall (N = 130)	P
SD: standard deviation; CAD: coronary artery disease; CVA: cerebrovascular accident; PAD: peripheral artery disease; CAS: carotid artery stenosis; CHF: congestive heart failure; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; SBP: systolic blood pressure; DBP: diastolic blood pressure; BPM: beats per minute; BMI: body mass index; HbA1c: glycosylated hemoglobin; OHA: oral hypoglycemic agent; ACE-I: angiotensin-converting enzyme inhibitor; ARB: angiotensin II receptor blocker.
Age mean (SD)	77.5 (6.3)	75.5 (7.3)	0.053
Gender
Male (n, %)	30 (44.8)	64 (49.2)	0.553
Female (n, %)	37 (55.2)	66 (50.8)
Race
Caucasian (n, %)	47 (70.2)	79 (60.8)	0.365
African-American (n, %)	9 (13.4)	27 (20.7)
Other (n, %)	11 (16.4)	24 (18.5)
Social factors
Cigarettes (n, %)	14 (20.9)	24 (18.5)	0.682
Alcohol (n, %)	15 (22.4)	48 (36.9)	0.038
Comorbidities
CAD (n, %)	44 (65.7)	55 (42.3)	0.002
CVA (n, %)	11 (16.4)	10 (7.7)	0.060
PAD (n, %)	32 (47.8)	42 (32.3)	0.034
Dementia (n, %)	19 (28.4)	16 (12.3)	0.026
Osteoarthritis (n, %)	46 (68.7)	89 (68.5)	0.978
CAS (n, %)	15 (22.4)	14 (10.8)	0.029
CHF (n, %)	17 (25.4)	17 (13.1)	0.030
Dizziness (n, %)	30 (44.8)	45 (34.6)	0.164
Anemia (n, %)	39 (58.2)	59 (45.4)	0.088
CKD (n, %)	38 (56.7)	75 (57.7)	0.896
COPD (n, %)	17 (25.4)	24 (18.5)	0.258
Syncope (n, %)	19 (28.4)	10 (7.7)	< 0.001
Peripheral neuropathy (n, %)	42 (62.7)	77 (59.2)	0.639
Bunions and callouses (n, %)	28 (41.8)	46 (35.4)	0.379
Hammertoe (n, %)	13 (19.4)	26 (20.0)	0.921
Vitals
SBP (mm Hg), mean (SD)	129 (13.7)	130 (13.0)	0.780
DBP (mm Hg), mean (SD)	73 (9.8)	73 (10.0)	0.560
Pulse (BPM), mean (SD)	75 (11.5)	75 (11.9)	0.560
Other parameters
BMI, mean (SD)	30.7 (6.5)	31.2 (6.9)	0.612
HbA1c, mean (SD)	7.1 (1.1)	7.2 (1.2)	0.419
Vitamin D (ng/mL), mean (SD)	37.1 (17.6)	32.8 (13.2)	0.097
Vitamin B₁₂ (µg/mL), mean (SD)	798.7 (520.3)	894.6 (787.4)	0.409
Medication
Statin (n, %)	55 (82.1)	105 (80.8)	0.822
Aspirin (n, %)	46 (68.7)	77 (59.2)	0.196
Insulin (n, %)	17 (25.4)	34 (26.2)	0.908
OHA (n, %)	51 (76.1)	101 (77.7)	0.803
ACE-I (n, %)	20 (29.9)	30 (23.1)	0.301
ARB (n, %)	27 (40.3)	53 (40.8)	0.949

Table 2. Baseline Characteristics Based on the Status of Falls

Variable

Fall (N = 67)

No fall (N = 130)

SD: standard deviation; CAD: coronary artery disease; CVA: cerebrovascular accident; PAD: peripheral artery disease; CAS: carotid artery stenosis; CHF: congestive heart failure; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; SBP: systolic blood pressure; DBP: diastolic blood pressure; BPM: beats per minute; BMI: body mass index; HbA1c: glycosylated hemoglobin; OHA: oral hypoglycemic agent; ACE-I: angiotensin-converting enzyme inhibitor; ARB: angiotensin II receptor blocker.

Age mean (SD)

77.5 (6.3)

75.5 (7.3)

0.053

Gender

Male (n, %)

30 (44.8)

64 (49.2)

0.553

Female (n, %)

37 (55.2)

66 (50.8)

Race

Caucasian (n, %)

47 (70.2)

79 (60.8)

0.365

African-American (n, %)

9 (13.4)

27 (20.7)

Other (n, %)

11 (16.4)

24 (18.5)

Social factors

Cigarettes (n, %)

14 (20.9)

24 (18.5)

0.682

Alcohol (n, %)

15 (22.4)

48 (36.9)

0.038

Comorbidities

CAD (n, %)

44 (65.7)

55 (42.3)

0.002

CVA (n, %)

11 (16.4)

10 (7.7)

0.060

PAD (n, %)

32 (47.8)

42 (32.3)

0.034

Dementia (n, %)

19 (28.4)

16 (12.3)

0.026

Osteoarthritis (n, %)

46 (68.7)

89 (68.5)

0.978

CAS (n, %)

15 (22.4)

14 (10.8)

0.029

CHF (n, %)

17 (25.4)

17 (13.1)

0.030

Dizziness (n, %)

30 (44.8)

45 (34.6)

0.164

Anemia (n, %)

39 (58.2)

59 (45.4)

0.088

CKD (n, %)

38 (56.7)

75 (57.7)

0.896

COPD (n, %)

17 (25.4)

24 (18.5)

0.258

Syncope (n, %)

19 (28.4)

10 (7.7)

< 0.001

Peripheral neuropathy (n, %)

42 (62.7)

77 (59.2)

0.639

Bunions and callouses (n, %)

28 (41.8)

46 (35.4)

0.379

Hammertoe (n, %)

13 (19.4)

26 (20.0)

0.921

Vitals

SBP (mm Hg), mean (SD)

129 (13.7)

130 (13.0)

0.780

DBP (mm Hg), mean (SD)

73 (9.8)

73 (10.0)

0.560

Pulse (BPM), mean (SD)

75 (11.5)

75 (11.9)

0.560

Other parameters

BMI, mean (SD)

30.7 (6.5)

31.2 (6.9)

0.612

HbA1c, mean (SD)

7.1 (1.1)

7.2 (1.2)

0.419

Vitamin D (ng/mL), mean (SD)

37.1 (17.6)

32.8 (13.2)

0.097

Vitamin B₁₂ (µg/mL), mean (SD)

798.7 (520.3)

894.6 (787.4)

0.409

Medication

Statin (n, %)

55 (82.1)

105 (80.8)

0.822

Aspirin (n, %)

46 (68.7)

77 (59.2)

0.196

Insulin (n, %)

17 (25.4)

34 (26.2)

0.908

OHA (n, %)

51 (76.1)

101 (77.7)

0.803

ACE-I (n, %)

20 (29.9)

30 (23.1)

0.301

ARB (n, %)

27 (40.3)

53 (40.8)

0.949

**Table 3.** Multivariable Logistic Regression Analysis
Variable	B	P	Exp(B)	95% CI for Exp(B)
Multivariable logistic regression analysis showing association between the independent variables and falls. B: beta weight; P: significance; Exp(B): odds ratio; CI: confidence interval; BMI: body mass index; HbA1c: glycosylated hemoglobin.
Age	-0.0.070	0.262	0.933	0.826	1.053
Gender male	-1.001	0.297	0.368	0.056	2.412
Cigarette smoking	1.111	0.242	3.036	0.473	19.478
Alcohol	-1.959	0.044	0.141	0.021	0.949
Anemia	1.583	0.020	4.868	1.282	18.485
BMI	0.046	0.394	1.047	0.942	1.185
HbA1c	-0.800	0.025	0.450	0.223	0.906
Podiatrist evaluation	-0.087	0.900	0.917	0.235	3.573

Table 3. Multivariable Logistic Regression Analysis

Variable

Exp(B)

95% CI for Exp(B)

Lower

Upper

Multivariable logistic regression analysis showing association between the independent variables and falls. B: beta weight; P: significance; Exp(B): odds ratio; CI: confidence interval; BMI: body mass index; HbA1c: glycosylated hemoglobin.

Age

-0.0.070

0.262

0.933

0.826

1.053

Gender male

-1.001

0.297

0.368

0.056

2.412

Cigarette smoking

1.111

0.242

3.036

0.473

19.478

Alcohol

-1.959

0.044

0.141

0.021

0.949

Anemia

1.583

0.020

4.868

1.282

18.485

BMI

0.046

0.394

1.047

0.942

1.185

HbA1c

-0.800

0.025

0.450

0.223

0.906

Podiatrist evaluation

-0.087

0.900

0.917

0.235

3.573