P.22 Mortality in 98 Type 1 Diabetes Mellitus (T1DM) and Type 2 Diabetes Mellitus (T2DM) Individuals Presenting to a Specialist Podiatry Clinic: Foot Ulcer Location is an Independent Risk Determinant

Heather Schofield; Samantha Haycocks; Adam Robinson; Simon G Anderson; Adrian Heald

doi:10.2991/artres.k.201209.035

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Volume 26, Issue Supplement 1, December 2020, Pages S44 - S44

P.22 Mortality in 98 Type 1 Diabetes Mellitus (T1DM) and Type 2 Diabetes Mellitus (T2DM) Individuals Presenting to a Specialist Podiatry Clinic: Foot Ulcer Location is an Independent Risk Determinant

Authors

Heather Schofield¹, Samantha Haycocks¹, Adam Robinson¹, Simon G Anderson², Adrian Heald¹^{, *}

¹Salford Royal NHS Foundation Trust

²University of the West Indies

^*Corresponding author. Email: adrian.heald@manchester.ac.uk

Corresponding Author

Adrian Heald

Available Online 31 December 2020.

DOI: 10.2991/artres.k.201209.035 How to use a DOI?
Keywords: Diabetes; foot U lcer; location; mortality
Abstract: Purpose/Background: We previously demonstrated in both longitudinal study and meta-analysis (pooled relative-risk RR, 2.45)[1,2] that all-cause and cardiovascular mortality is significantly higher in people with diabetes foot ulceration (DFU) than with those without a foot ulcer. In this prospective study, we looked at the factors linked to mortality after presentation to podiatry with DFU.

Methods: 98 individuals recruited consecutively from the Salford Royal Hospital Multidisciplinary Foot Clinic in Spring 2016 were followed for up to 48 months. Data concerning health outcomes were extracted from the electronic patient record (EPR).

Results: Seventeen people (17) had type 1 diabetes mellitus (T1DM), and 81 had type 2 diabetes mellitus (T2DM). 31 were women. The mean age (range) was 63.6 (28–90) years with maximum diabetes duration 45 years. Mean HbA1c was 72 (95% CI: 67–77) mmol/mol. 97% had neuropathy (International Working Group on the Diabetic Foot (IWGDF) monofilament) [2]. 62% had vascular insufficiency (Doppler studies). 69% of ulcers were forefoot and 23% of ulcers were hind foot in location. 40/98 (39.2%) died in follow-up with 27% of death certificates including sepsis (not foot-related) and 35% renal failure as cause of death. Multivariate regression analysis indicated a 6.3 (95% CI 3.9–8.1) fold increased risk of death with hind foot ulcer, independent of age/BMI/gender/HbA1c/eGFR/total cholesterol level.

Conclusion: This prospective study has shown a close relation between risk of sepsis/renal failure and presentation to a specialist podiatry clinic with hind foot ulceration an independent risk factor, highlighting again the importance of addressing cardiovascular risk factors [3] as soon as people present with DFU.
Copyright: © 2020 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V.
Open Access: This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

REFERENCES

[1]S Saluja, SG Anderson, I Hambleton, H Shoo, M Livingston, EB Jude, et al., Foot ulceration and its association with mortality in diabetes mellitus: a meta-analysis, Diabet Med, Vol. 37, 2020, pp. 211-18.

[2]NC Schaper, JJ van Netten, J Apelqvist, SA Bus, RJ Hinchlife, and BA Lipsky, IWGDF Guidelines on the prevention and management of diabetic foot disease. Available from: iwgdfguidelines.org/wp-content/uploads/2019/05/IWGDF-Guidelines-2019.pdf. (accessed May 24, 2020).

[3]A Heald, M Lunt, MK Rutter, SG Anderson, G Cortes, M Edmonds, et al., Developing a foot ulcer risk model: what is needed to do this in a real-world primary care setting?, Diabet Med, Vol. 36, 2019, pp. 1412-16.

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Journal: Artery Research
Volume-Issue: 26 - Supplement 1
Pages: S44 - S44
Publication Date: 2020/12/31
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.2991/artres.k.201209.035 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

ris enw bib

TY  - JOUR
AU  - Heather Schofield
AU  - Samantha Haycocks
AU  - Adam Robinson
AU  - Simon G Anderson
AU  - Adrian Heald
PY  - 2020
DA  - 2020/12/31
TI  - P.22 Mortality in 98 Type 1 Diabetes Mellitus (T1DM) and Type 2 Diabetes Mellitus (T2DM) Individuals Presenting to a Specialist Podiatry Clinic: Foot Ulcer Location is an Independent Risk Determinant
JO  - Artery Research
SP  - S44
EP  - S44
VL  - 26
IS  - Supplement 1
SN  - 1876-4401
UR  - https://doi.org/10.2991/artres.k.201209.035
DO  - 10.2991/artres.k.201209.035
ID  - Schofield2020
ER  -

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