Diabetic foot disease carries an intrinsic high risk of mortality and other severe outcomes in type 2 diabetes : a propensity score-matched retrospective population-based study
Vlacho, Bogdan (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Bundó, Magdalena (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Llussà, Judit (Institut Català de la Salut)
Real, Jordi (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Mata-Cases, Manel (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Cos Claramunt, Francesc Xavier (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Tundidor, Diana (Institut de Recerca Sant Pau)
Zaccardi, Francesco (University of Leicester)
Khunti, Kamlesh (University of Leicester)
Jude, Edward B. (University of Manchester)
Franch-Nadal, Josep (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Mauricio Puente, Dídac (Institut de Recerca Sant Pau)
Universitat Autònoma de Barcelona

Date:	2024
Abstract:	Background: To evaluate the association between diabetic foot disease (DFD) and the incidence of fatal and non-fatal events in individuals with type 2 diabetes (T2DM) from primary-care settings. Methods: We built a cohort of people with a first DFD episode during 2010-2015, followed up until 2018. These subjects were 1 to 1 propensity score matched to subjects with T2DM without DFD. The incidence of all-cause mortality, the occurrence of new DFD, amputations, cardiovascular diseases, or composite outcome, including all-cause mortality and/or cardiovascular events during the follow-up period, were calculated. A Cox proportional hazard analysis was conducted to evaluate the hazard ratios (HR) for different events. Results: Overall, 11,117 subjects with T2DM with a first episode of DFD were compared with subjects without DFD. We observed higher incidence rates (IRs) for composite outcome (33. 9 vs. 14. 5 IR per 100 person-years) and a new DFD episode event (22. 2 vs. 1. 1 IR per 100 person-years) in the DFD group. Compared to those without DFD, those with a first episode of DFD had a higher HR for all events, with excess rates particularly for amputation and new DFD occurrence (HR: 19. 4, 95% CI: 16. 7-22. 6, HR: 15. 1, 95% CI: 13. 8-16. 5, respectively) was found. Conclusions: Although DFD often coexists with other risk factors, it carries an intrinsic high risk of morbidity and mortality in individuals with T2DM. DFD should be regarded as a severe complication already at its onset, as it carries a poor clinical prognosis. Graphical Abstract: (Figure presented. ).
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Amputation ; Cardiovascular events ; Diabetic foot disease ; Incidence ; Primary healthcare ; Severe outcomes
Published in:	Cardiovascular diabetology, Vol. 23 Núm. 1 (december 2024) , p. 209, ISSN 1475-2840

DOI: 10.1186/s12933-024-02303-1
PMID: 38898525

10 p, 1.5 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
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