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

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.

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

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.

Risk factors associated with diabetic foot ulcer-free survival in patients with diabetes

2018 ◽  
Vol 12 (6) ◽  
pp. 1039-1043 ◽  
Author(s):  
Leila Yazdanpanah ◽  
Hajieh Shahbazian ◽  
Iraj Nazari ◽  
Saeed Hesam ◽  
Fatemeh Ahmadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Free Survival ◽  
Factors Associated ◽  
Patients With Diabetes

scholarly journals The risk factors of developing diabetic foot ulcers incidence with diabetic patients in Mukalla/Yemen

2020 ◽  
Author(s):  
مريم باراس ◽  
Eidha A. Bin Hameed
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Glucose ◽  
Bacterial Infection ◽  
Diabetic Foot ◽  
Age Groups ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Patients With Diabetes

Background: Diabetes is on the rise worldwide and is already considered as an epidemic by some experts. So, there is a need to raise awareness on the important factors that can help prevent bacterial infection in wounds of patients with diabetes. Objective: To study the risk factors of developing diabetic foot ulcer (DFU) in patients with diabetes. The study is the first in Yemen to investigate the prevalence of bacterial infection in wounds of diabetic patients. Materials and Methods: This is a case-control study carried out from November 2018 to May 2019. Twenty diabetic patients with foot ulcer and twenty without foot ulcer were examined. Risk factors and clinical profile of patients were studied by using a standardized questionnaire that included gender, age groups, past history of diabetes, duration of the disease, type of diabetes, DFU, type of ulcer, smoking, glucose level, and control of blood glucose level. Results: The risk factors that affected significantly the occurrence of DFU were gender (0.038), age groups (0.010), and duration of diabetes mellitus (DM) while hyperglycemic control, smoking, and family history were not. There was no significant difference (0.977) in mean fasting blood glucose (MBG) between the DM and DFU patients. Conclusions: Male diabetic patients aged more than 55 years and suffering from DM for more than 10 years were most likely to have DFU. Key words: diabetic foot ulcer, diabetes mellitus, risk factors, Yemen 

scholarly journals Risk Factors for Diabetic Foot Ulcers in Metreleptin Naïve Patients With Lipodystrophy

2021 ◽  
Author(s):  
Onur Saydam ◽  
Basak Ozgen Saydam ◽  
Suleyman Cem Adiyaman ◽  
Melda Sonmez Ince ◽  
Mehmet Ali 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 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.

scholarly journals Knowledge of Risk Factors for Foot Ulceration among Patients with Diabetes Mellitus Attending a Tertiary Health Facility in Nigeria

2021 ◽  
Author(s):  
Martins Ehizode Emuze ◽  
Taoreed Adegoke Azeez ◽  
Arinola Esan ◽  
Jokotade Adeleye ◽  
William Balogun ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Health Facility ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Foot Ulceration ◽  
Validated Questionnaire ◽  
Patients With Diabetes

Objective: Diabetic foot ulcer (DFU) is a relatively common complication of diabetes mellitus and constitutes a major cause of mortality. This study aimed to assess the knowledge of risk factors for foot ulceration among patients with diabetes in a tertiary health facility in South Western Nigeria. Materials and Methods: This cross-sectional study was initiated with participation of 100 diabetic patients. Diabetic patients were attending the medical outpatient clinic of the University College Hospital, Ibadan. A structured and validated questionnaire was administered and data was analyzed using SPSS 22. Association between sociodemographic characteristics and knowledge of risk factors for foot ulceration was evaluated by chi-square test. Results: Most of respondents were female (66%). The mean age of the patients was 58.77 (±11.8) years and 51% of patients did not know that it is possible to develop foot ulcer without feeling pain and 30% did not know that features suggestive of neuropathy could be associated with development of foot ulcer. 75% did not know that surgical vascular repair could play any role in the healing of a diabetic foot ulcer. 11% of patients were walking barefooted at home and as much as 63% of respondents did not know that poor longterm glycemic control could be a risk factor for the development of diabetic foot ulcers. Conclusion: The knowledge of the patients attending the diabetes clinic of a tertiary hospital in south-western Nigeria on foot care is generally poor. Education in this direction is very paramount to correct this defect.

Diabetic Foot Complications Despite Successful Pancreas Transplantation

2017 ◽  
Vol 38 (6) ◽  
pp. 656-661 ◽  
Author(s):  
Dong-Kyo Seo ◽  
Ho Seong Lee ◽  
Jungu Park ◽  
Chang Hyun Ryu ◽  
Duck Jong Han ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Pancreas Transplantation ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot And Ankle ◽  
Charcot Arthropathy ◽  
Level Of Evidence ◽  
Foot Complications ◽  
Patients With Diabetes ◽  
Normal Glucose Level

Background: It is known that successful pancreas transplantation enables patients with diabetes to maintain a normal glucose level without insulin and reduces diabetes-related complications. However, we have little information about the foot-specific morbidity in patients who have undergone successful pancreas transplantation. The purpose of this study was to investigate the prevalence and predisposing factors for foot complications after successful pancreas transplantation. Methods: This retrospective study included 218 patients (91 males, 127 females) who had undergone pancreas transplantation for diabetes. The mean age was 40.7 (range, 15-76) years. Diabetes type, transplantation type, body mass index, and diabetes duration before transplantation were confirmed. After pancreas transplantation, the occurrence and duration of foot and ankle complications were assessed. Results: Twenty-two patients (10.1%) had diabetic foot complications. Fifteen patients (6.9%) had diabetic foot ulcer and 7 patients (3.2%) had Charcot arthropathy. Three patients had both diabetic foot ulcer and Charcot arthropathy. Three insufficiency fractures (1.4%) were included. Mean time of complications after transplantation was 18.5 (range, 2-77) months. Creatinine level 1 year after surgery was higher in the complication group rather than the noncomplication group ( P = .02). Conclusion: Complications of the foot and ankle still occurred following pancreas transplantation in patients with diabetes. Level of Evidence: Level III, comparative study

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

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.

scholarly journals A Survey of Nurses’ Knowledge Regarding Prevention and Management of Diabetic Foot Ulcer in Bangladesh

2014 ◽  
Vol 4 (1) ◽  
pp. 22-26 ◽  
Author(s):  
S Sharmisthas ◽  
P Wongchan ◽  
S Hathairat
Keyword(s):  
Diabetic Foot ◽  
Callus Formation ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Care Program ◽  
Foot Care ◽  
Multiple Choice Questions ◽  
Patients With Diabetes ◽  
Protective Sensation ◽  
Nurses Knowledge

Diabetic foot ulcer is a preventable complication of diabetes. Nurses must have knowledge related to this condition so that education can be given to patients. This study aims to examine the level of nurses’ knowledge regarding prevention and management of diabetic foot ulcer in Bangladesh. A survey involved 218 nurses working at a national, specialized, and well-established institute of diabetic care of Bangladesh. The Nurses’ Knowledge Regarding Prevention and Management of Diabetic Foot Ulcer Questionnaire (NKPMDFUQ) comprising of 40 questions with 20 true/false questions and 20 multiple choice questions was used. It was content validated and tested for internal consistency and stability yielding acceptable levels of reliability. The findings revealed that nurses had very low level of knowledge (M=52.60%, SD=7.86%). The content areas most nurses did not have knowledge were detecting loss of protective sensation of the feet, caring of callus formation, encouraging patients to have activity of daily living in order to self-manage, setting a goal for prevention of amputation, and giving advice to patients that causes of diabetes is the least important element in diabetic foot care program. The findings are beneficial for establishing training courses. Consequently, quality of care for patients with diabetes will be improved. DOI: http://dx.doi.org/10.3329/birdem.v4i1.18549 Birdem Med J 2014; 4(1): 22-26

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