The 10-year follow-up of a community-based cohort of people with diabetes : the incidence of foot ulceration and death
Abstract
Background: Identifying people with diabetes who are likely to experience a foot ulcer is an important part of preventative care. Many cohort studies report predictive models for foot ulcerations and for people with diabetes, but reports of long-term outcomes are scarce. Aim: We aimed to develop a predictive model for foot ulceration in diabetes using a range of potential risk factors with a follow-up of 10 years after recruitment. A new foot ulceration was the outcome of interest and death was the secondary outcome of interest. Design: A 10-year follow-up cohort study. Methods: 1193 people with a diagnosis of diabetes who took part in a study in 2006–2007 were invited to participate in a 10-year follow-up. We developed a prognostic model for the incidence of incident foot ulcerations using a survival analysis, Cox proportional hazards model. We also utilised survival analysis Kaplan–Meier curves, and relevant tests, to assess the association between the predictor variables for foot ulceration and death. Results: At 10-year follow-up, 41% of the original study population had died and more than 18% had developed a foot ulcer. The predictive factors for foot ulceration were an inability to feel a 10 g monofilament or vibration from a tuning fork, previous foot ulceration and duration of diabetes. Conclusions: The prognostic model shows an increased risk of ulceration for those with previous history of foot ulcerations, insensitivity to a 10 g monofilament, a tuning fork and duration of diabetes. The incidence of foot ulceration at 10-year follow-up was 18%; however, the risk of death for this community-based population was far greater than the risk of foot ulceration.
Citation
Shijat , M , Crawford , F , Cezard , G I & Papathomas , M 2023 , ' The 10-year follow-up of a community-based cohort of people with diabetes : the incidence of foot ulceration and death ' , Endocrinology, Diabetes & Metabolism , vol. Early View , e459 . https://doi.org/10.1002/edm2.459
Publication
Endocrinology, Diabetes & Metabolism
Status
Peer reviewed
DOI
10.1002/edm2.459ISSN
2398-9238Type
Journal article
Description
Funding: This work was funded as part of a wider project by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme (HTA project: 15/171/01).Collections
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