Aims/Introduction To assess the association between vitamin D and diabetic foot (DF) in patients with type 2 diabetes mellitus (T2DM), in order to summarize clinical evidence in the prevention and treatment of DF. Materials and methods Between January 2012 and December 2019, a total of 1,721 hospitalized patients with type 2 diabetes mellitus were continuously enrolled in West China Hospital, Sichuan University, and divided into DF and non‐DF groups according to whether they had DF, and divided into four subgroups according to the admission season. The 25‐OH‐vitamin D levels were compared between groups and subgroups, and independent risk factors discussed for the occurrence of DF. Results The vitamin D insufficiency and deficiency rate were higher in the DF group (77.51%) than in the non‐DF group (59.2%). The 25‐OH‐vitamin D levels were lower in the DF group (35.80 nmol/L) than in the non‐DF group (45.48 nmol/L) ( P < 0.001). Patients with poor glycemic control had lower 25‐OH‐vitamin D levels ( P = 0.01). The levels of 25‐OH‐vitamin D were lower in winter and spring. In the same season, the levels of 25‐OH‐vitamin D in patients with DF were still lower ( P < 0.001). The 25‐OH‐vitamin D levels of patients with Wagner grades 0 to 5 showed a downward trend ( P = 0.114). The 25‐OH‐vitamin D level was independently associated with diabetic foot ( P < 0.001, OR = 0.986). Conclusions The low serum vitamin D level was significantly associated with a higher prevalence of DF among Chinese patients with type 2 diabetes mellitus. Although vitamin D levels vary seasonally, patients with DF were always at higher risk of having vitamin D insufficiency and deficiency.

Objectives: Diabetic foot ulcers (DFUs) are a considerable burden on patients and the healthcare service system. Patients with DFUs have many risk factors that might contribute to obstructive sleep apnea (OSA). The purposes of this study were to assess the prevalence of OSA and associated features in patients with DFUs. Methods: Between July 2017 and June 2019, we recruited 245 consecutive patients who sought for treatment at West China Hospital because of DFUs. Polysomnography data from 127 Patients were included in the final analysis. Results: Of the 127 patients, with a median age of 64 years (interquartile range, 55–73 years; range, 36–86 years) and a mean body mass index (BMI) 24.09 ± 0.37 kg/m 2 , 91 (72%) were men. The prevalence of OSA [apnea–hypopnea index (AHI) ≧5/h] was 92% in men and 97% in women ( P = 0.304). Moderate to severe OSA (AHI ≧15/h) was noted in 44 men (48%) and 26 women (72%) ( P = 0.015). The risk factors associated with the severity of OSA were sex, age, smoking, alcohol use, and duration of diabetes. After multivariable adjustment, duration of diabetes and age were independent predictive factors of the severity of OSA. No significant association was observed between BMI, waist circumference, Epworth score, and the severity of OSA. There were no significant associations between OSA and ischemic heart disease, cerebral infarction, hypertension, diabetic retinopathy, diabetic kidney disease, and peripheral artery disease. Conclusions: The prevalence of OSA was high in patients with DFUs, with moderate to severe OSA accounting for more than half of the patients. Age and duration of diabetes were independent predictive factors of the severity of OSA.

Background: The quality of life (QoL) of diabetic foot ulcer patients is worse than that of diabetic patients. The Diabetic Foot Ulcer Scale-Short Form (DFS-SF) is a readily available instrument used to evaluate the quality of life of diabetic foot ulcer individuals. The aim of this study was to translate the DFS-SF into Chinese, followed by an evaluation of its validity and reliability. Methods: This study was conducted in two phases. In the first phase, we followed the Brislin’s Translation and Back-translation model to translate the DFS-SF into Mandarin Chinese. In the second phase, we examined the reliability and validity of the Chinese version of the DFS-SF, where the reliability was assessed in terms of Cronbach’s α coefficient, split-half reliability, and test-retest reliability, and validation of the scale was carried out through content validity, structure validity and criterion validity approaches. Results: A total of 208 participants were recruited for our study. The item-level content validity index (I-CVI) of the Chinese version of the Diabetic Foot Ulcer Scale varied from 0.800 to 1.000, the average scale-level content validity index (S-CVI/Ave) was 0.911, and the Cronbach’s α coefficient of the scale was 0.952. Confirmatory factor analysis indicated good structural validity of the scale, with a Comparative Fit Index (CFI) = 0.920 and a root mean square error of approximation (RMSEA) of 0.069 (p < 0.001). The criterion-related validity results indicated that the subscales were significantly related to the subscales of the 36-Item Short-Form Health Survey (SF-36), with coefficients ranging from 0.116 to 0.571 (p < 0.05). Discussion: The translation and the examination of the scale rigidly followed the golden standard model, and the reliability observed in our study was similar to that of other studies. Furthermore, the validity assessment indicated that the scale structure was reliable. Therefore, the proposed scales may serve as a reliable instrument for the quality of life evaluation in the diabetic foot ulcers population. Conclusion: The adaptation and validation of the Chinese version of the Diabetic Foot Ulcers Scale-Short Form were reliable, and it will be a reliable instrument to evaluate the QoL of Chinese diabetic foot ulcer patients.

BackgroundPolysomnography (PSG) is the gold standard for diagnosis of sleep-disordered breathing (SDB). But it is impractical to perform PSG in all patients with diabetes. The objective was to develop a clinically easy-to-use prediction model to diagnosis SDB in patients with diabetes.MethodsA total of 440 patients with diabetes were recruited and underwent overnight PSG at West China Hospital. Prediction algorithms were based on oxygen desaturation index (ODI) and other variables, including sex, age, body mass index, Epworth score, mean oxygen saturation, and total sleep time. Two phase approach was employed to derivate and validate the models.ResultsODI was strongly correlated with apnea-hypopnea index (AHI) (rs = 0.941). In the derivation phase, the single cutoff model with ODI was selected, with area under the receiver operating characteristic curve (AUC) of 0.956 (95%CI 0.917–0.994), 0.962 (95%CI 0.943–0.981), and 0.976 (95%CI 0.956–0.996) for predicting AHI ≥5/h, ≥15/h, and ≥30/h, respectively. We identified the cutoff of ODI 5/h, 15/h, and 25/h, as having important predictive value for AHI ≥5/h, ≥15/h, and ≥30/h, respectively. In the validation phase, the AUC of ODI was 0.941 (95%CI 0.904–0.978), 0.969 (95%CI 0.969–0.991), and 0.949 (95%CI 0.915–0.983) for predicting AHI ≥5/h, ≥15/h, and ≥30/h, respectively. The sensitivity of ODI ≥5/h, ≥15/h, and ≥25/h was 92%, 90%, and 93%, respectively, while the specificity was 73%, 89%, and 85%, respectively.ConclusionsODI is a sensitive and specific tool to predict SDB in patients with diabetes.

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