Puguang Xie1, Bo Deng1, Xi Zhang1, Yuyao Li1, Chenzhen Du1, Shunli Rui1, Wu Deng2, Johnson Boey3, David G Armstrong4, Yu Ma1, Wuquan Deng1. 1. Department of Endocrinology, College of Medicine, College of Bioengineering, Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing University, Chongqing, China. 2. College of Electronic Information and Automation, Civil Aviation University of China, Tianjin, China. 3. Department of Podiatry, National University Hospital, Singapore. 4. Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA.
Abstract
AIMS: The aim of this study was to evaluate the association of time in range (TIR) with amputation and all-cause mortality in hospitalised patients with diabetic foot ulcers (DFUs). MATERIALS AND METHODS: A retrospective analysis was performed on 303 hospitalised patients with DFUs. During hospitalisation, TIR, mean blood glucose (MBG), coefficient of variation (CV), time above range (TAR) and time below range (TBR) of patients were determined from seven-point blood glucose profiles. Participants were grouped based on their clinical outcomes (i.e., amputation and death). Logistic regression was employed to analyse the association of TIR with amputation and all-cause mortality of inpatients with DFUs. RESULTS: Among the 303 enrolled patients, 50 (16.5%) had undergone amputation whereas seven (2.3%) were deceased. Blood glucose was determined in 41,012 samples obtained from all participants. Patients who underwent amputation had significantly lower TIR and higher MBG, CV, level 2 TAR and level 1 TBR whereas deceased patients had significantly lower TIR and higher MBG and level 2 TAR. Both amputation and all-cause mortality rate declined with an increase in TIR quartiles. Logistic regression showed association of TIR with amputation (p = 0.034) and all-cause mortality (p = 0.013) after controlling for 15 confounders. This association was similarly significant in all-cause mortality after further adjustment for CV (p = 0.022) and level 1 TBR (p = 0.021), respectively. CONCLUSIONS: TIR is inversely associated with amputation and all-cause mortality of hospitalised patients with DFUs. Further prospective studies are warranted to establish a causal relationship between TIR and clinical outcomes in patients with DFUs.
AIMS: The aim of this study was to evaluate the association of time in range (TIR) with amputation and all-cause mortality in hospitalised patients with diabetic foot ulcers (DFUs). MATERIALS AND METHODS: A retrospective analysis was performed on 303 hospitalised patients with DFUs. During hospitalisation, TIR, mean blood glucose (MBG), coefficient of variation (CV), time above range (TAR) and time below range (TBR) of patients were determined from seven-point blood glucose profiles. Participants were grouped based on their clinical outcomes (i.e., amputation and death). Logistic regression was employed to analyse the association of TIR with amputation and all-cause mortality of inpatients with DFUs. RESULTS: Among the 303 enrolled patients, 50 (16.5%) had undergone amputation whereas seven (2.3%) were deceased. Blood glucose was determined in 41,012 samples obtained from all participants. Patients who underwent amputation had significantly lower TIR and higher MBG, CV, level 2 TAR and level 1 TBR whereas deceased patients had significantly lower TIR and higher MBG and level 2 TAR. Both amputation and all-cause mortality rate declined with an increase in TIR quartiles. Logistic regression showed association of TIR with amputation (p = 0.034) and all-cause mortality (p = 0.013) after controlling for 15 confounders. This association was similarly significant in all-cause mortality after further adjustment for CV (p = 0.022) and level 1 TBR (p = 0.021), respectively. CONCLUSIONS: TIR is inversely associated with amputation and all-cause mortality of hospitalised patients with DFUs. Further prospective studies are warranted to establish a causal relationship between TIR and clinical outcomes in patients with DFUs.
Authors: Chenzhen Du; Yuyao Li; Puguang Xie; Xi Zhang; Bo Deng; Guixue Wang; Youqiang Hu; Min Wang; Wu Deng; David G Armstrong; Yu Ma; Wuquan Deng Journal: Int Wound J Date: 2021-11-24 Impact factor: 3.099
Authors: Min He; Tianyi Chen; Yuhuan Lv; Peiyang Song; Bo Deng; Xuewen Guo; Shunli Rui; Johnson Boey; David G Armstrong; Yu Ma; Wuquan Deng Journal: Front Bioeng Biotechnol Date: 2022-09-29