Sophia Rossboth1, Benedikt Rossboth, Hans Schoenherr2,3, Christian Ciardi3, Monika Lechleitner4, Willi Oberaigner2. 1. Research Unit for Diabetes Epidemiology, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT-Private University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria. sophia.rossboth@edu.umit.at. 2. Research Unit for Diabetes Epidemiology, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT-Private University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria. 3. Department of Internal Medicine, St. Vinzenz Hospital Zams, Zams, Austria. 4. Department of Internal Medicine, Hospital Hochzirl, Zirl, Austria.
Abstract
BACKGROUND: Diabetic foot complications, one of the most severe late complications of type 2 diabetes mellitus, are associated with a tremendous personal and financial burden. In order to drive the prevention of diabetic foot complications forward and facilitate early detection and personalized screening of high-risk patients, longitudinal studies are needed to identify risk factors associated with diabetic foot complications in large patient datasets. METHODS: This is a retrospective cohort study on 3002 patients with type 2 diabetes mellitus aged ≥ 18 years without prior foot complications. The data were collected between 2006 and 2017 in an Austrian hospital department specialized for diabetic patients. In addition to a univariate Cox regression analysis, multivariate Cox regression models were established to identify independent risk factors associated with diabetic foot complications and adjust for potential confounders. RESULTS: We observed a total of 61 diabetic foot complications in 3002 patients. In the multivariate Cox regression model, significant risk factors (hazard ratio, 95% confidence interval) for foot complications were age at diagnosis > 70 years (3.39, 1.33-8.67), male gender (2.55, 1.42-4.55), neuropathy (3.03, 1.74-5.27), peripheral arterial disease (3.04, 1.61-5.74), hypertension > 10 years after diagnosis (2.32, 1.09-4.93) and HbA1c > 9% (2.44, 1.02-5.83). CONCLUSION: The identified risk factors for diabetic foot complications suggest that personalized early detection of patients at high risk might be possible by taking the patient's clinical characteristics, medical history and comorbidities into account. Modifiable risk factors, such as hypertension and high levels of blood glucose might be tackled to reduce the risk for diabetic foot complications.
BACKGROUND: Diabetic foot complications, one of the most severe late complications of type 2 diabetes mellitus, are associated with a tremendous personal and financial burden. In order to drive the prevention of diabetic foot complications forward and facilitate early detection and personalized screening of high-risk patients, longitudinal studies are needed to identify risk factors associated with diabetic foot complications in large patient datasets. METHODS: This is a retrospective cohort study on 3002 patients with type 2 diabetes mellitus aged ≥ 18 years without prior foot complications. The data were collected between 2006 and 2017 in an Austrian hospital department specialized for diabetic patients. In addition to a univariate Cox regression analysis, multivariate Cox regression models were established to identify independent risk factors associated with diabetic foot complications and adjust for potential confounders. RESULTS: We observed a total of 61 diabetic foot complications in 3002 patients. In the multivariate Cox regression model, significant risk factors (hazard ratio, 95% confidence interval) for foot complications were age at diagnosis > 70 years (3.39, 1.33-8.67), male gender (2.55, 1.42-4.55), neuropathy (3.03, 1.74-5.27), peripheral arterial disease (3.04, 1.61-5.74), hypertension > 10 years after diagnosis (2.32, 1.09-4.93) and HbA1c > 9% (2.44, 1.02-5.83). CONCLUSION: The identified risk factors for diabetic foot complications suggest that personalized early detection of patients at high risk might be possible by taking the patient's clinical characteristics, medical history and comorbidities into account. Modifiable risk factors, such as hypertension and high levels of blood glucose might be tackled to reduce the risk for diabetic foot complications.
Authors: L Prompers; M Huijberts; N Schaper; J Apelqvist; K Bakker; M Edmonds; P Holstein; E Jude; A Jirkovska; D Mauricio; A Piaggesi; H Reike; M Spraul; K Van Acker; S Van Baal; F Van Merode; L Uccioli; V Urbancic; G Ragnarson Tennvall Journal: Diabetologia Date: 2008-07-22 Impact factor: 10.122
Authors: Andrew J M Boulton; David G Armstrong; Stephen F Albert; Robert G Frykberg; Richard Hellman; M Sue Kirkman; Lawrence A Lavery; Joseph W Lemaster; Joseph L Mills; Michael J Mueller; Peter Sheehan; Dane K Wukich Journal: Diabetes Care Date: 2008-08 Impact factor: 19.112