Department of Public Health, Research Unit for Diabetes Epidemiology, Health Services Research and Health Technology Assessment, Medical Informatics and Technology, UMIT-Private University for Health Sciences, Hall i.T., Austria.
Department of Internal Medicine, St. Vinzenz Hospital Zams, Zams, Austria.
Endocrinol Diabetes Metab. 2021 Oct;4(4):e00286. doi: 10.1002/edm2.286. Epub 2021 Jul 13.
Diabetic foot complications, a serious consequence of diabetes mellitus, are associated with a tremendous burden on both individual patients and health care systems. Since prevention strategies may reduce the incidence of this complication, identification of risk factors in large longitudinal studies is essential to optimize early detection and personalized screening of patients at increased risk.
We conducted a registry-based retrospective cohort study using data from 10,688 patients with type 2 diabetes mellitus aged ≥18 years. Cox regression models were used to identify risk factors for foot complications while adjusting for potential confounders.
We observed 140 diabetic foot complications in our patient cohort. The multivariate Cox regression model revealed neuropathy, peripheral arterial disease and male gender as being positively associated with foot complications. The same effect was detected for nephropathy in the time >10 years after T2DM diagnosis. For higher age at diagnosis and use of insulin, however, a negative association was retrieved.
Male gender and several diabetes-related comorbidities were identified as risk factors for subsequent initial foot complications in patients with type 2 diabetes mellitus. These findings suggest that personalized early detection of patients at increased risk might be feasible by using information on demographics, medical history and comorbidities.
糖尿病足并发症是糖尿病的严重后果,给患者个人和医疗保健系统都带来了巨大负担。由于预防策略可能会降低这种并发症的发生率,因此在大型纵向研究中确定风险因素对于优化高危患者的早期检测和个性化筛查至关重要。
我们使用了 10688 名年龄≥18 岁的 2 型糖尿病患者的数据,进行了一项基于登记的回顾性队列研究。使用 Cox 回归模型,在调整潜在混杂因素的情况下,确定了足部并发症的风险因素。
在我们的患者队列中观察到 140 例糖尿病足并发症。多变量 Cox 回归模型显示,神经病变、外周动脉疾病和男性与足部并发症呈正相关。在 2 型糖尿病诊断后 10 年以上,肾病也有同样的影响。然而,对于更高的诊断年龄和胰岛素使用,我们发现了负相关。
男性和几种与糖尿病相关的合并症被确定为 2 型糖尿病患者随后发生初始足部并发症的危险因素。这些发现表明,通过使用人口统计学、病史和合并症等信息,对高危患者进行个性化的早期检测可能是可行的。