Six‐year incidence of lower extremity arterial disease and associated risk factors in Type 1 diabetic African‐Americans

Roy, Monique; Peng, Bocheng

doi:10.1111/j.1464-5491.2008.02434.x

Cited by 5 publications

(3 citation statements)

References 35 publications

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“…Description of studies Fourteen prospective studies [2,10,12,[20][21][22][23][32][33][34][35][36][37][38] involving 94,640 participants and 1,227 LEA cases were included. Details of study characteristics are provided ( Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…When a study published more than one paper, we included the publication with the longest follow-up or largest sample size. In order to maximise the available information, we retained three studies [20][21][22] that combined endpoints such as peripheral vascular disease with amputations, assessing the effect of this inclusion through subgroup analysis. We selected 17 studies for inclusion and corresponded with the authors of five [21,[23][24][25][26], of whom two [21,23] provided data, enabling us to calculate relative risks for the 14 studies in this review (Fig.…”

Section: Study Selectionmentioning

confidence: 99%

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Association between glycated haemoglobin and the risk of lower extremity amputation in patients with diabetes mellitus—review and meta-analysis

et al. 2010

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Aims/hypothesis Diabetes increases the risk of lower extremity amputation (LEA). Although epidemiological studies report positive associations between glycaemia and LEA, the magnitude of the risk is not adequately quantified and clinical trials to date have not provided conclusive evidence about glucose lowering and LEA risk. We synthesised the available prospective epidemiological data on the association between glycaemia measured by HbA 1c and the risk of LEA in individuals with diabetes. Methods We searched electronic databases and reference lists of relevant articles. We considered prospective epidemiological studies that had measured HbA 1c level and assessed LEA as an outcome among diabetic individuals without acute foot ulcerations or previous history of amputation. Of 2,548 citations identified, we included 14 studies comprising 94,640 participants and 1,227 LEA cases. We abstracted data using standardised forms and obtained data from investigators when required. Data included characteristics of study populations, HbA 1c assay methods, outcome and covariates. Study-specific relative risk estimates were pooled using random-effects model meta-analysis; heterogeneity was explored with metaregression analyses. Results The overall RR for LEA was 1.26 (95% CI 1.16-1.36) for each percentage point increase in HbA 1c . There was considerable heterogeneity across studies (I 2 76%, 67-86%; p<0.001), which was not accounted for by recorded study characteristics. The estimated RR was 1.44 (95% CI 1.25-1.65) for type 2 diabetes and 1.18 (95% CI 1.02-1.38) for type 1 diabetes; however, the difference was not statistically significant (p=0.09). We found no strong evidence for publication bias. Conclusions/interpretation There is a substantial increase in risk of LEA associated with glycaemia in individuals with diabetes. In the absence of conclusive evidence from trials, this paper provides further epidemiological support for glucose-lowering as a strategy to reduce amputation in a population without acute foot ulceration or former amputation; it also provides disease modellers with estimates to assess the overall burden of hyperglycaemia.

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Section: Resultsmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Association between glycated haemoglobin and the risk of lower extremity amputation in patients with diabetes mellitus—review and meta-analysis

et al. 2010

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“…92 In addition, a prospective study in African-Americans with T1DM found that DR severity at baseline was a significant independent risk factor for the incidence of lower extremity arterial disease, defined as present if a patient has had an amputation or angioplasty for poor circulation, or if there is an absence of major arterial pulse in the legs. 93 However, in patients with T2DM, a borderline ABI (0.90-0.99) has been identified as an independent predictor of DR and other microvascular and macrovascular complications. 94…”

Section: Peripheral Complicationsmentioning

confidence: 99%

Association between diabetic eye disease and other complications of diabetes: Implications for care. A systematic review

Pearce

Simó

Lövestam-Adrian

et al. 2018

Diabetes Obesity Metabolism

140

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Aims: To evaluate diabetic retinopathy (DR) screening with a portable handheld smartphone-based retinal camera and telemedicine in an urban primary health care setting; to evaluate the learning curve for image acquisition, performed by healthcare personnel without previous experience on retinal imaging. Methods: Prospective study that enrolled patients with type 2 diabetes mellitus (T2DM) followed at a primary healthcare unit in São Paulo, Brazil. After a brief training in image acquisition, there was further continuous feedback during the remote image reading process. Each patient underwent two fundus and one anterior ocular segment images per eye, after mydriasis. Patients were classi ed according need of referral. Results: A total of 627 adult individuals with T2DM underwent retinal evaluation. The population was composed by 63.2% female individuals, age median of 66 years-old, diabetes duration 10.7 ± 8.2 years and A1c 7.7 ± 1.9% (61 + 20.8 mmol/mol). The most prevalent associated comorbidities were arterial hypertension (80.3%) and dyslipidemia (50.2%). Referral decision was possible in 81.2% patients. Most patients had absent or non-referable DR; the main ocular media opacity detected was cataract. After the 7 th day of image acquisition, the daily rate of patients whose images allowed clinical decision was maintained above 80%. A higher A1c was associated with referable DR. Conclusion: A low-cost DR screening strategy with a handheld device and telemedicine is feasible and has the potential to increase coverage of DR screening in underserved areas; the possibility of mobile units is relevant for DR screening in the context of Covid-19 pandemic.

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Current literature in diabetes

2008

Diabetes Metabolism Res

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of diabetes/metabolism. Each bibliography is divided into 26 sections: 1 Reviews; 2 General; 3 Genetics; 4 Epidemiology; 5 Immunology; 6 Obesity; 7 Prediction and Prevention; 8 Intervention: a) General; b) Care; c) Drug Therapy; d)Economics; e) Gene therapy; f) Nursing; g) Nutrition; h) Surgery; i) Transplantation; 9 Pathology and Complications: a) General; b) Cardiovascular; c) Eye disease; d) Gestational and fetal; e) Neurological; f) Podiatrical; g) Renal; 10 Endocrinology & Metabolism; 11 Experimental Studies; 12 Diagnosis and Techniques. Within each section, articles are listed in alphabetical order with respect to author

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Six‐year incidence of lower extremity arterial disease and associated risk factors in Type 1 diabetic African‐Americans

Abstract: Blood pressure control and prevention and treatment of foot ulcers may be helpful in reducing the morbidity associated with LEAD in African-Americans with Type 1 diabetes.

Cited by 5 publications

References 35 publications

Association between glycated haemoglobin and the risk of lower extremity amputation in patients with diabetes mellitus—review and meta-analysis

Association between glycated haemoglobin and the risk of lower extremity amputation in patients with diabetes mellitus—review and meta-analysis

Association between diabetic eye disease and other complications of diabetes: Implications for care. A systematic review

Current literature in diabetes

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