Prevalence and the Determinants of Foot Ulcers Among Patients with Diabetes Mellitus: A Nationwide Survey (TEMD-2 Diabetic Foot Study)

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Abstract
Objective: The prevalence of diabetic foot (DF) increases with the prolonged life expectancy. Identification of factors associated with an increased risk of DF is crucial to establish preventive measures. This study aimed to update the frequency of DF and assess risk factors for DF among patients with diabetes mellitus (DM) across tertiary care centers in Türkiye. Methods: Turkish nationwide survey of glycemic and other Metabolic parameters of patients with Diabetes mellitus-2 (TEMD-2) study is a national multicenter cross-sectional survey that included patients with DM in 70 centers in Türkiye. Current or past physician-diagnosed DF was recorded and confirmed by physical exam. Along with the common comorbidities, foot-related risk factors, including ulcer, previous amputation history, and Charcot foot, were recorded in patients with a history of DF. Results: The study included 5570 patients with DM (mean age: 56.3 ± 12.7 years, women: 59.4%). The prevalence of DF was 4.7%. Male sex, lower educational level, peripheral artery disease, retinopathy, neuropathy, and poor glycemic control were independently associated with a DF diagnosis. Statin use was associated with lower DF risk among type 2 diabetic patients. Among foot-related factors, ulcers were the most frequent finding in half of the patients with DF. Conclusion: The prevalence of DF in this study was similar to the European average. Although several non-modifiable and modifiable factors were independently associated with an increased risk of DF, statin use was associated with a beneficial effect. Cite this article as: Cetinarslan B, Demirci I, Haymana C, et al. Prevalence and the determinants of foot ulcers among patients with diabetes mellitus: A nationwide survey (TEMD-2 diabetic foot study). Endocrinol Res Pract. Published online August 1, 2026. doi: 10.5152/erp.2026.25794.