Diabetic Foot Complications: A Retrospective Cohort Study

Abstract

Diabetes mellitus is a highly prevalent disease globally and contributes to significant morbidity and mortality. As a consequence of multiple pathophysiologic changes which are associated with diabetes, these patients frequently suffer from foot-related disorders: infections, ulcerations, and gangrene. Approximately half of all amputations occur in diabetic individuals, usually as a complication of diabetic foot ulcers. In this retrospective study, we analyzed and characterized a cohort of 69 patients and their diabetes-related foot complications. The main characteristics of our cohort were as follows: older age at diagnosis (mean age 66); higher incidence of diabetes in males; predominantly urban patient population. The most frequent complications of the lower extremity were ulcerations and gangrene. Moreover, in our study, 35% of patients required surgical reintervention, and 27% suffered from complications, while 13% required ICU admission. However, diabetic foot lesions are preventable via simple interventions which pointedly reduce foot amputations. Early identification and the appropriate medical and surgical treatment of the complications associated with diabetic foot disease are important because they still remain common, complex and costly.

The Efficacy of Diabetic Foot Treatment in a “TOSF” Pattern: A Five-Year Retrospective Study

“… 26 The mortality rate of patients aged < 65 years was 8.5%, which was lower than that of patients aged ≥ 65 years, which was consistent with the results of other studies that an increase of age led to greater mortality. 29 However, the higher incidence of other complications in younger patients was inconsistent with other studies, 26 and we propose that the higher mortality rate in elderly patients may have led to that result. The longer the course of the disease, the higher is the prevalence and mortality of diabetic foot, 3 , 26 which is consistent with the results of the present study.…”

“… 24 , 25 This is associated with men’s poor physical and mental self-care ability as well as poor joint flexibility and higher foot pressure. 26–28 Patients aged < 65 years accounted for 51.5%, which was also in agreement with the trend of diabetic foot in youth. 26 The mortality rate of patients aged < 65 years was 8.5%, which was lower than that of patients aged ≥ 65 years, which was consistent with the results of other studies that an increase of age led to greater mortality.…”

“… 26–28 Patients aged < 65 years accounted for 51.5%, which was also in agreement with the trend of diabetic foot in youth. 26 The mortality rate of patients aged < 65 years was 8.5%, which was lower than that of patients aged ≥ 65 years, which was consistent with the results of other studies that an increase of age led to greater mortality. 29 However, the higher incidence of other complications in younger patients was inconsistent with other studies, 26 and we propose that the higher mortality rate in elderly patients may have led to that result.…”

Single Nucleotide Polymorphisms of the RAC1 Gene as Novel Susceptibility Markers for Neuropathy and Microvascular Complications in Type 2 Diabetes

“…The study of Rossboth S. and co-workers found a positive association of DFS with the male sex [ 85 ]. The pathogenesis of DFS has been linked to a variety of conditions, including oxidative stress, the malfunction of polyol and inositol metabolism, increased Na/K-ATPase activity, endoneural microvascular deficits and ischemia, defective axonal transport, and the non-enzymatic glycosylation of proteins in peripheral neurons [ 86 , 87 ].…”

Ulcer occurrence on adjacent toes and hallux valgus deformity after amputation of the second toe in diabetic patients

“…Vascular and neuropathic diseases, diabetes mellitus [ 28 ], infections [ 4 ], injuries [ 16 ], malignancy [ 19 ], severe deformities [ 29 ], and other irreversible tissue damages necessitate amputations of toes for further damage control [ 1 – 3 , 12 , 14 ]. Toe amputations are considered minor surgical procedures; however, the re-amputation rate is quoted high in the literature with up to 60% [ 12 , 14 ] and this might ensue further surgical and medical treatment [ 5 , 30 ].…”