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 Bundo, Magdalena Llussa, Judit Real, Jordi Mata-Cases, Manel Cos, Xavier Tundidor, Diana Zaccardi, Francesco Khunti, Kamlesh Jude, Edward B.
Vlacho, Bogdan
Bundo, Magdalena
Llussa, Judit
Real, Jordi
Mata-Cases, Manel
Cos, Xavier
Tundidor, Diana
Zaccardi, Francesco
Khunti, Kamlesh
Jude, Edward B.
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.
MIDER Authors
Affiliations
Citations
Altmetric:
Date
2024-06-19
Type
Article
Collections
Citation
Vlacho, B., Bundó, M., Llussà, J., Real, J., Mata-Cases, M., Cos, X., Tundidor, D., Zaccardi, F., Khunti, K., Jude, E. B., Franch-Nadal, J., & Mauricio, D. (2024). 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. Cardiovascular diabetology, 23(1), 209. https://doi.org/10.1186/s12933-024-02303-1