Standard complication screening information can be used for risk assessment for first time foot ulcer among patients with type 1 and type 2 diabetes
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Standard complication screening information can be used for risk assessment for first time foot ulcer among patients with type 1 and type 2 diabetes. / Hangaard, Sine; Rasmussen, Anne; Almdal, Thomas; Nielsen, Annemette Anker; Nielsen, Kirsten Engelhart; Siersma, Volkert; Holstein, Per.
I: Diabetes Research and Clinical Practice, Bind 151, 2019, s. 177-186.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Standard complication screening information can be used for risk assessment for first time foot ulcer among patients with type 1 and type 2 diabetes
AU - Hangaard, Sine
AU - Rasmussen, Anne
AU - Almdal, Thomas
AU - Nielsen, Annemette Anker
AU - Nielsen, Kirsten Engelhart
AU - Siersma, Volkert
AU - Holstein, Per
PY - 2019
Y1 - 2019
N2 - Aim Diabetic foot ulcer (DFU) is a major complication of both Type 1 Diabetes (T1D) and Type 2 Diabetes (T2D); however research into risk factors for DFU does not separate between these two types. The purpose of the present investigation was to identify risk factors for development of first time DFU (FTDFU) over a period of 15 years in patients with T1D and T2D separately. Methods This retrospective cohort study included 25,220 feet from 5588 patients with T1D and 7113 patients with T2D treated in the period 2001–2015. Data on baseline characteristics and comorbidities were collected from electronic patient records. Influences of various risk factors for the development of FTDFU were assessed by hazard ratios (HR) from Cox proportional hazard regression models on time from enrolment to FTDFU diagnosis or end-of-follow-up. Results In T1D independent risk factors were male sex, age >60 years, high HbA1c, long diabetes duration, history of cardiovascular disease, macro-albuminuria, decreased visual acuity, advanced diabetic retinopathy, decreased/absent vibration sense, presence of patient reported symptoms of neuropathy, and absence of foot pulses. In T2D the independent risk factors were the same except age >60 years, a history of cardiovascular disease, and long diabetes duration. Conclusions This study documents that much of the standard clinical information obtained as part of the routine follow-up are also independent risk factors for development of FTDFU. This may be used to create a basis for in which patient and when prevention should be started.
AB - Aim Diabetic foot ulcer (DFU) is a major complication of both Type 1 Diabetes (T1D) and Type 2 Diabetes (T2D); however research into risk factors for DFU does not separate between these two types. The purpose of the present investigation was to identify risk factors for development of first time DFU (FTDFU) over a period of 15 years in patients with T1D and T2D separately. Methods This retrospective cohort study included 25,220 feet from 5588 patients with T1D and 7113 patients with T2D treated in the period 2001–2015. Data on baseline characteristics and comorbidities were collected from electronic patient records. Influences of various risk factors for the development of FTDFU were assessed by hazard ratios (HR) from Cox proportional hazard regression models on time from enrolment to FTDFU diagnosis or end-of-follow-up. Results In T1D independent risk factors were male sex, age >60 years, high HbA1c, long diabetes duration, history of cardiovascular disease, macro-albuminuria, decreased visual acuity, advanced diabetic retinopathy, decreased/absent vibration sense, presence of patient reported symptoms of neuropathy, and absence of foot pulses. In T2D the independent risk factors were the same except age >60 years, a history of cardiovascular disease, and long diabetes duration. Conclusions This study documents that much of the standard clinical information obtained as part of the routine follow-up are also independent risk factors for development of FTDFU. This may be used to create a basis for in which patient and when prevention should be started.
KW - Type 1 Diabetes
KW - Type 2 Diabetes
KW - Complications
KW - Foot ulcers
KW - Diabetic foot ulcers
U2 - 10.1016/j.diabres.2019.04.021
DO - 10.1016/j.diabres.2019.04.021
M3 - Journal article
C2 - 31004675
VL - 151
SP - 177
EP - 186
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
SN - 0168-8227
ER -
ID: 222157157