Risk factors associated with diabetic foot amputation among patients hospitalized for diabetic foot ulcer in a public hospital

Abstract AimPatients with lipodystrophy are at high risk for chronic complications of diabetes. Recently, we have reported 18 diabetic foot ulcer episodes in 9 subjects with lipodystrophy. This current study aims to determine risk factors associated with foot ulcer development in this rare disease population.MethodsNinety metreleptin naïve patients with diabetes registered in our national lipodystrophy database were included in this observational retrospective cohort study (9 with and 81 without foot ulcers).Results Patients with lipodystrophy developing foot ulcers had longer diabetes duration (p = 0.007), longer time since lipodystrophy diagnosis (p = 0.008), and higher HbA1c levels (p = 0.041). Insulin use was more prevalent (p = 0.003). The time from diagnosis of diabetes to first foot ulcer was shorter for patients with generalized lipodystrophy compared to partial lipodystrophy (p = 0.036). Retinopathy (p < 0.001), neuropathy (p < 0.001), peripheral artery disease (p = 0.001), and kidney failure (p = 0.003) were more commonly detected in patients with foot ulcers. Patients with foot ulcers tended to have lower leptin levels (p = 0.052). Multiple logistic regression estimated significant associations between foot ulcers and generalized lipodystrophy (OR: 40.81, 95%CI: 3.31 - 503.93, p = 0.004), long-term diabetes (≥ 15 years; OR: 27.07, 95%CI: 2.97 - 246.39, p = 0.003), and decreased eGFR (OR: 13.35, 95%CI: 1.96 - 90.67, p = 0.008).ConclusionOur study identified several clinical factors associated with foot ulceration among patients with lipodystrophy and diabetes. Preventive measures and effective treatment of metabolic consequences of lipodystrophy are essential to prevent the occurrence of foot ulcers in these high-risk individuals.

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Risk factors associated with poor outcome in diabetic foot ulcer patients

TURKISH JOURNAL OF MEDICAL SCIENCES ◽

10.3906/sag-1602-119 ◽

2017 ◽

Vol 47 ◽

pp. 826-831 ◽

Cited By ~ 5

Author(s):

Saira SALEEM ◽

Nazim HAYAT ◽

Irshad AHMED ◽

Tanvir AHMED ◽

Abdul Gaffar REHAN

Keyword(s):

Risk Factors ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Factors Associated ◽

Poor Outcome

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Risk factors of amputation in diabetic foot infections

International Surgery Journal ◽

10.18203/2349-2902.isj20181118 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1399 ◽

Cited By ~ 1

Author(s):

Quraysh Shabbir Sadriwala ◽

Bapuji S. Gedam ◽

Murtaza A. Akhtar

Keyword(s):

Risk Factors ◽

Peripheral Neuropathy ◽

Glycemic Control ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Poor Glycemic Control ◽

Diabetic Patients ◽

Factors Associated ◽

Diabetic Foot Infections

Background: Diabetes is the most common underlying cause of foot ulcers, infection, and ischemia, leading to hospitalization and the most frequent cause of non-traumatic lower extremity amputation. Despite well-defined risk factors for diabetic foot ulcer development, limited data are available as to which factors predict amputation in a diabetic foot ulcer episode. Therefore, to predict lower limb amputation occurrence and to determine the factors associated with the risk of amputation in diabetic patients, we conducted this study.Methods: A hospital based longitudinal study was carried out to assess the risk factors associated with amputation in diabetic foot infection. Patients with foot infections, who were either a diagnosed case of diabetes mellitus or were diagnosed at the institute were included in the study. We excluded patients receiving immunosuppressive therapy or radiotherapy, and infections at or above the ankle joint. Study factors were demographic details, biochemical parameters, Wagner grading, peripheral neuropathy as evaluated by nerve conduction test and vasculopathy as assessed by Ankle brachial index. The primary outcome factor was amputation. The data was presented as descriptive statistics and analyzed by dividing the patients into amputation and non-amputation group, and univariate and multivariate analysis was done.Results: A total of 64 patients were included in the study, out of which the amputation rate was 39.1%. Poor glycemic control, osteomyelitis, vasculopathy, peripheral neuropathy and Wagner grading were statistically significant.Conclusions: In the present study, poor glycemic control, vasculopathy, peripheral neuropathy and higher Wagner grade are significant risk factors for amputation in diabetic foot infections.

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Risk factors for diabetic foot ulcers in metreleptin naïve patients with lipodystrophy

Clinical Diabetes and Endocrinology ◽

10.1186/s40842-021-00132-9 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

O Saydam ◽

B Ozgen Saydam ◽

SC Adiyaman ◽

M Sonmez Ince ◽

MA Eren ◽

...

Keyword(s):

Risk Factors ◽

High Risk ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Foot Ulcers ◽

Partial Lipodystrophy ◽

Factors Associated ◽

Patients With Diabetes ◽

Artery Disease

Abstract Aim Patients with lipodystrophy are at high risk for chronic complications of diabetes. Recently, we have reported 18 diabetic foot ulcer episodes in 9 subjects with lipodystrophy. This current study aims to determine risk factors associated with foot ulcer development in this rare disease population. Methods Ninety metreleptin naïve patients with diabetes registered in our national lipodystrophy database were included in this observational retrospective cohort study (9 with and 81 without foot ulcers). Results Patients with lipodystrophy developing foot ulcers had longer diabetes duration (p = 0.007), longer time since lipodystrophy diagnosis (p = 0.008), and higher HbA1c levels (p = 0.041). Insulin use was more prevalent (p = 0.003). The time from diagnosis of diabetes to first foot ulcer was shorter for patients with generalized lipodystrophy compared to partial lipodystrophy (p = 0.036). Retinopathy (p < 0.001), neuropathy (p < 0.001), peripheral artery disease (p = 0.001), and kidney failure (p = 0.003) were more commonly detected in patients with foot ulcers. Patients with foot ulcers tended to have lower leptin levels (p = 0.052). Multiple logistic regression estimated significant associations between foot ulcers and generalized lipodystrophy (OR: 40.81, 95% CI: 3.31–503.93, p = 0.004), long-term diabetes (≥ 15 years; OR: 27.07, 95% CI: 2.97–246.39, p = 0.003), and decreased eGFR (OR: 13.35, 95% CI: 1.96–90.67, p = 0.008). Conclusions Our study identified several clinical factors associated with foot ulceration among patients with lipodystrophy and diabetes. Preventive measures and effective treatment of metabolic consequences of lipodystrophy are essential to prevent the occurrence of foot ulcers in these high-risk individuals.

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Prevalence and Factors Associated With Diabetic Foot Ulcer among Adult Patients in Ayder Referral Hospital Diabetic Clinic Mekelle, North Ethiopia, 2013

Journal of Diabetes & Metabolism ◽

10.4172/2155-6156.1000579 ◽

2015 ◽

Vol 06 (08) ◽

Cited By ~ 4

Author(s):

Kahsu Gebrekirstos Solomon

Keyword(s):

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Referral Hospital ◽

Adult Patients ◽

Factors Associated ◽

Diabetic Clinic ◽

Ayder Referral Hospital

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A clinico-microbiological study of diabetic foot ulcer patients to identify risk factors and their correlation with prognosis in tertiary care hospital in India

International Surgery Journal ◽

10.18203/2349-2902.isj20161141 ◽

2016 ◽

pp. 669-673 ◽

Cited By ~ 1

Author(s):

Arun Anand ◽

Indu Biswal ◽

Rajesh Soni ◽

Ajit Sinha ◽

Dabet Rynga ◽

...

Keyword(s):

Risk Factors ◽

Diabetic Foot ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Care Hospital ◽

Microbiological Study

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Causation Research on Diabetic Foot Complications—What I Learned From Roger Pecoraro: The 2021 Roger E. Pecoraro Award Lecture

10.2337/figshare.15048282 ◽

2021 ◽

Author(s):

Edward J. Boyko

Keyword(s):

Risk Factors ◽

Diabetic Foot ◽

Past History ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Clinical Information ◽

Arterial Perfusion ◽

Primary Care Population ◽

Foot Complications ◽

Patients With Diabetes

Roger Pecoraro made important contribution to diabetic foot research and is primarily responsible for instilling in me an interest in these complications. Our collaboration in the final years of his life led to the development of the Seattle Diabetic Foot Study. At the time it began, the Seattle Diabetic Foot Study was perhaps unique in being a prospective study of diabetic foot ulcer conducted in a non-specialty primary care population of patients with diabetes and without foot ulcer. Important findings from this research include the demonstration that neurovascular measurements, diabetes characteristics, past history of ulcer or amputation, body weight, and poor vision all significantly and independently predict foot ulcer risk. A prediction model from this research that included only readily available clinical information showed excellent ability to discriminate between patients who did and did not develop ulcer during follow-up (area under ROC curve=0.81 at one year). Identification of limb-specific amputation risk factors showed considerable overlap with those risk factors identified for foot ulcer, but suggested arterial perfusion as playing a more important role. Risk of foot ulcer in relation to peak plantar pressure estimated at the site of the pressure measurement showed a significant association over the metatarsal heads, but not other foot locations, suggesting that the association between pressure and this outcome may differ by foot location. The Seattle Diabetic Foot Study has helped to expand our knowledge base on risk factors and potential causes of foot complications. Translating this information into preventive interventions remains a continuing challenge.

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