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Hi

I am involved in a research project on the epidemiology of diabetic foot ulcer and part of the scope of this is to determine its prevalence, if any, in children and adolescents, or more specifically to find evidence that it does not occur or is extremely rare in this population.

I want to be able to state that diabetic foot ulcer does not occur in children but despite a quite extensive search, I have been unable to find any research articles or literature reviews that can specifically show this.

Diabetic foot ulcer incidence as a complication of diabetes clearly rises with age and the duration of the diabetes and the mean age of sufferers seems to be in the region of 40 to 50 years old. If I could find evidence, say, of a case study of the youngest known sufferer of diabetic foot ulcer and this individual was an adult then that would be good evidence of the argument that this disease does not occur in children.

Can anyone help me with my research query?

Regards

Duncan

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Hypothetically it could, but I never seen it nor heard of it. Especially in the context of how early the subclinical neurophysiological changes start to happen.

In a review of the national data base of diabetes related amputations in 2 countries, the youngest I came across was in their late 20's.

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Craig Payne
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God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.

Duncan,

You will find that it is extremely rare for children and adolecense to develop any on the secondary complications of diabetes. (retinopathy, Nephropathy, neuropathy) as they all take time to develop. You should be able to find data in the DCCT results, especially around retinopathy, which will correlate to neuropathy.

I have in the past provided services through a transition clinic (kids to adult hospital with age group of 16-30+) and have never come across a diabetes related ulcer in the under 20s, but have seen them in people in their late 20s, and have had reduced sensation in some younger.

A neuropathic ulcer though can occur in younger children as a result of sensory neuropathy that may be hereditory. Such children may also have diabetes.

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Stephen Tucker
Calvary Health Care

My location

Yes, it occurs. I have treated adolescents with diabetic ulcers. Not very frequent, I would estimate I have seen it three or four times, but the epidemic of childhood obesity and proliferation of NIDDM here is obvious.
Most recently, I treated a 19-year-old diabetic with advanced co-morbidities, but his eventual amputation may be due to an unusual and little-studied hypercoagulability state related to AIDS. I have not yet reviewed his extensive studies- Protein C, S, antithrombin 3, etc...

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Dr. John G. Fasick II
Clinical Insructor, LSU School of Medicine
Advanced Foot & Ankle Center of East Jefferson
footankledoc2@gmail.com

Hi John

Thanks very much for your reply. I am very interested in the fact that you have treated adolescents with diabetic [foot] ulcers (DFU)

I have been creating a document to show the prevalence of DFU in children, which has been leading to the conclusion that it doesn't exist. I have not found any evidence in the scientific literature or anywhere else until I received your comment which suggests that it is not in fact unknown, albeit rare. Until now the youngest patients I had heard of with this diease were in the 20's - mostly late 20s.

I would very much like to hear more about these few cases you have experience of - the age they were particularly - and anything else you could tell me about them.

Regards


Duncan J Currie PhD
Senior Medical Writer
Pharmaceutical Product Development (PPD)