scholarly journals Survival of Patients Following First Diagnosis of Diabetic Foot Complications: A Nationwide 15-Year Longitudinal Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Chia-Hung Lin ◽  
David G. Armstrong ◽  
Pi-Hua Liu ◽  
Cheng-Wei Lin ◽  
Chung-Huei Huang ◽  
...  

Background and AimsThe long-term survival in people with type 2 diabetes following first diagnosis of diabetic foot complications (FDDFC) is unclear. The object is to evaluate the mortality rate in subjects with type 2 diabetes following FDDFC and the impacts of the major cardiovascular comorbidities.MethodsNationwide data were analyzed for subjects with T2D and DFC between 2003 and 2017 according to ICD-9 coding. DFC was defined with the codes of ulcers, infections, or severe peripheral artery disease that required intervention (PAD) to mimic the real world diagnosis. Criteria of FDDFC were preceded by a period without any DFC for at least 5 years. Major cardiovascular comorbidities: established PAD and cardiovascular diseases (CVD: including coronary heart disease (CHD), stroke, or heart failure) before the index date as well as lower-extremity amputations (LEA) at the index episode were analyzed.ResultsAmong 300,115 subjects with DFC, a total of 103,396 patients had FDDFC. The mean 5-year survival rate of these subjects was 81.05%. Using subjects without associated major cardiovascular comorbidity as baseline, the adjusted hazard ratios (aHR) were1.43 (95% confidence interval 1.38–1.49) in group PAD-/CVD+, followed by 1.70 (1.59–1.80) in PAD+/CVD- and 1.98 (1.89–2.08) in PAD+/CVD+. The aHR was further increased in patients with PAD who additionally had heart failure (3.77, 3.50–4.05), stroke (2.06, 1.95–2.18), or CHD (1.89, 1.79–2.00). Subjects with PAD rather than other CVD were associated with LEA at FDDFC. Patients with major LEA (above the ankle) at FDDFC episode had lower 5-year survival rate (65.01%) followed by those with minor LEA (72.24%) and without LEA (81.61%).ConclusionsCardiovascular comorbidity as well as LEA status at the event of FDDFCs were both associated with patient survival outcomes. Earlier identification of this large population could lead to higher survival rates.

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Xiao-fen Xiong ◽  
Ling Wei ◽  
Ying Xiao ◽  
Ya-Chun Han ◽  
Jinfei Yang ◽  
...  

Abstract To investigate the relationship between diabetic foot complications (DFCs) and clinical characteristics, especially the number and types of first-degree family members with diabetes. A total of 8909 type 2 diabetes patients were enrolled. The clinical characteristics of these patients, including DFCs and family history of diabetes (FHD), were collected from medical records. Multiple regression was used to investigate the association between FHD and DFCs after adjusting for confounding factors. The patients with one and more than one first-degree family member with diabetes accounted for 18.7% and 12.8%, respectively. The proportions of the participants with a father with diabetes, a mother with diabetes, both parents with diabetes, siblings with diabetes, father and siblings with diabetes, mother and siblings with diabetes, and both parents and siblings with diabetes were 3.5%, 6.2%, 1.1%, 14.4%, 1.5%, 4%, and 0.7%, respectively. The multiple regression analysis showed that the number of family members with diabetes was positively associated with DFCs. However, among the different types of FHD, only the patients with a mother with diabetes showed a statistical association with DFCs. In addition to FHD, other factors, including gender, body mass index, platelet count, hemoglobin levels, albumin levels, high-density cholesterol levels, diabetic peripheral neuropathy, and the use of lipid-lowering agents, oral hypoglycemic agents, and insulin, were also associated with DFCs. DFCs were associated with different numbers of family members with diabetes and types of FHD. This association reveals the importance of genetic and environmental factors in DFCs and highlights the importance of adding FHD to public health strategies targeting detecting and preventing the disease.


2018 ◽  
Vol 17 (3) ◽  
pp. 169-175 ◽  
Author(s):  
Arun Gundmi Maiya ◽  
Shubha Gundmi ◽  
Prabhath Matpady ◽  
Radhika Jadhav ◽  
Ramachandra Lingadakai ◽  
...  

The objective of the study was to determine the prevalence of foot complications among people with type 2 diabetes mellitus in the rural part of Udupi district, Karnataka, India. A cross-sectional observational study design was conducted in the rural area of Udupi district. In the study, accredited social health activists were trained to screen people with type 2 diabetes mellitus for diabetic foot complications at a community level. Adults over 35 years of age were screened for the presence of type 2 diabetes mellitus by accredited social health activists who reside in the rural part of Udupi district. Participants with type 2 diabetes mellitus were included in the study. Blood glucose level was measured using a glucometer. Foot examination was done by visual inspection, monofilament, tuning fork, and pedal pulse. In the present study, 2110 among the total participants were found to have type 2 diabetes mellitus. The prevalence of musculoskeletal foot complications was 1218 (58%), vascular problem 466 (22.2%), sensory neuropathy 634 (30.2%), autonomic neuropathy 1729 (81.9%), ulcer 134 (6.38%), and infection 561 (26.7%) among people with type 2 diabetes mellitus. In the current study, we found 84.7% of people residing in rural Udupi had type 2 diabetes mellitus. Hence, there is a strong need to create awareness about diabetic foot care in these people.


2016 ◽  
Vol 22 ◽  
pp. 20-21
Author(s):  
Aditya D. Raju ◽  
Anna D. Coutinho ◽  
Weijia Wang ◽  
Sharash Shetty ◽  
Stephen S. Sander ◽  
...  

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1142-P
Author(s):  
DOMINIC PILON ◽  
MICHAEL DURKIN ◽  
AMEUR MANCEUR ◽  
ISABELLE GHELERTER ◽  
MARIE-HÉL LAFEUILLE ◽  
...  

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1130-P
Author(s):  
JINGWEI LI ◽  
BRUCE NEAL ◽  
HIDDO L. HEERSPINK ◽  
CLARE ARNOTT ◽  
CHRISTOPHER CANNON ◽  
...  

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