Study links diabetic foot ulcers with higher risk of death, heart attack and stroke
(Medical Xpress)—People with diabetes who develop foot ulcers are at more risk of dying prematurely than those without the complication, finds a new large-scale study. The researchers say the findings highlight the potential need for improved detection and management of those with diabetes and foot ulcers.
The study, which is the largest analysis of diabetes into the link between foot ulcers and the condition, is published in this month's (November) edition of the journal Diabetologia.
There are 3.7million people diagnosed with diabetes in the UK, including an estimated 850,000 people who have the condition but do not know it. Diabetes can damage a person's blood vessels and nerves, especially if their blood sugar is poorly controlled. Poor circulation and nerve damage in the feet makes people vulnerable to unnoticed cuts or other injuries and progress into poorly healing ulcers, or sores. In severe cases, this can lead to foot or leg amputation.
In a study of 17,830 patients with diabetes – 3,095 diagnosed with foot ulceration and 14,735 without – researchers from St George's, University of London investigated how diabetic foot ulcers affected a person's risk of dying earlier. They found that those with a history of foot ulceration had a higher death rate than those without. There were an extra 58 deaths per 1,000 people each year with diabetic foot ulcers.
The investigators analysed patient records from eight studies, conducted in Europe, America, Australasia and South-East Asia, published between 2006 and 2011. The length of time the health of participants was followed for varied between an average of two and 10 years for each of the studies.
People with foot ulcers and diabetes showed more cardiovascular risk factors, such as high blood pressure, and were more likely to die from cardiovascular causes. Approximately half of the additional mortalities were due to cardiovascular disease, such as heart attack or stroke.
The cause of non-cardiovascular deaths was not studied as part of this investigation but the researchers say this is potentially linked to infections and complications of foot ulceration, such as blood poisoning.
Robert Hinchliffe from St George's, University of London, who co-led the study, said: "Our research, which is the largest and therefore most reliable study to date, shows that people with diabetes who have foot ulcers are at considerably higher risk of an earlier death compared to those patients without. We suspect that this may be due in part to the effect of infections among those with foot ulcers and the greater co-existence of cardiovascular disease and foot ulcers with diabetes although the reasons are not entirely clear."
The researchers say these results underline the importance of a two-pronged approach for people with diabetes: enhanced foot ulceration screening as early detection and treatment may help reduce some of the complications; and more intensive control of blood pressure and cholesterol among those diagnosed with foot ulcers as they are at higher cardiovascular risk.
Currently, experts already recommend that people with diabetes undertake a number of precautions to prevent foot ulcers including blood sugar control, wearing socks to prevent cuts, self-checking for abrasions and getting a complete foot examination at least once a year.
Existing guidelines to prevent cardiovascular disease include healthy diet choices, regular exercise, a medical check-up at least once a year and, often, medically prescribed drug treatment.
Professor Kausik Ray, who also co-led the study, said: "Our results warrant further investigation as to whether even greater control of risk factors such as blood pressure, blood glucose and early preventative screening can further reduce mortality among those with foot ulcers. There is likely an unmet potential to reduce deaths in this group."
More information: Diabetologia, Volume 55, Number 11 (2012), 2906-2912, DOI: 10.1007/s00125-012-2673-3, 'The association of ulceration of the foot with cardiovascular and all-cause mortality in patients with diabetes: a meta-analysis', J. R. W. Brownrigg, J. Davey, P. J. Holt, W. A. Davis, M. M. Thompson, K. K. Ray and R. J. Hinchliffe. http://www.springerlink.com/content/m773660227386615/
Provided by St. George's University of London
- Factors ID'd in healing failure of diabetic foot ulcers Jun 15, 2012 | not rated yet | 0
- Diabetics with previous foot ulcers may be able to participate in walking program Jan 13, 2009 | not rated yet | 0
- Team approach to foot care lowers risk of amputation in diabetes Aug 19, 2010 | not rated yet | 0
- The Medical Minute: November is diabetes month Nov 11, 2010 | not rated yet | 0
- Specialists must work together to prevent leg amputations, urge experts Apr 17, 2012 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
gravity is std. therefore can we rate a 'mass at height' by watts?
1 hour ago For example.... wind turbines are primarily listed by their wattage (1.5MW etc.) Presumably their output is varied according to rotational speed, so...
Calculating on-axis elements of a solenoid
13 hours ago I wanted to mention that this solenoid has many winds over many layers. The thickness of the windings is 2.4 inches coming off of the engineering...
latitude & longitude & air pressure
14 hours ago Hi there, I have a peculiar question. Imagine that you are in a earth position, obtained by google, that gives you the latitude and longitude....
Differences of Classical Mechanics when learned with Calc vs algebra?
17 hours ago what are the differences? Every example I find usually has a derivative or integral or some kind of calculus defined concept that seems to make it...
what is the distance traveled
21 hours ago A rough sketch of experiment. Image: http://i43.tinypic.com/14t4sk5.png the red dots represent a side view of path traveled, F is downward force...
Image of a Convex Lens Cut in Half Horizontally
May 22, 2013 Hello everyone, A friend of mine came up with this question in class and I really do not have a good answer. Suppose you have a convex lens...
- More from Physics Forums - Classical Physics
More news stories
Widely-used fish oil supplements modestly increase amounts of a hormone that is associated with lower risk of diabetes and heart disease, according to a study accepted for publication in The Endocrine Society's Journal of ...
Diabetes 20 hours ago | 5 / 5 (1) | 0
Study shows that women who smoke during pregnancy increase the risk of both obesity and gestational diabetes in their da
Women who smoke during pregnancy increase the risk of both obesity and gestational diabetes, in their daughters, concludes research published in Diabetologia, the journal of the European Association for the Study of Diabet ...
Diabetes May 20, 2013 | not rated yet | 0
The number of young people diagnosed with type 2 diabetes has seen the sharpest rise over the last twenty years compared to a background of a general increase across the board, new University research has ...
Diabetes May 20, 2013 | not rated yet | 0
(Medical Xpress)—Flinders University researchers are breaking new ground in a decade-long journey to pinpoint the function of two closely related proteins.
Diabetes May 20, 2013 | 5 / 5 (2) | 0 |
(HealthDay)—Moderate aerobic exercise prevents fructose-induced hypertriglyceridemia in healthy males, according to a study published online May 14 in Diabetes.
Diabetes May 17, 2013 | 5 / 5 (1) | 0 |
(Medical Xpress)—Research by U of T Mississauga psychology professor Glenn Schellenberg reveals that two key personality traits – openness-to-experience and conscientiousness—predict better than IQ ...
1 hour ago | not rated yet | 0 |
Professor Michael Jennings, Deputy Director of the Institute for Glycomics at Griffith University, was part of an international team that discovered the previously unknown pathway of how the bacterium colonizes people.
43 minutes ago | 5 / 5 (1) | 0 |
Scientists at Newcastle University have shed new light on how the brain tunes in to relevant information.
40 minutes ago | 5 / 5 (1) | 0 |
New techniques in imaging of brain activity developed by Jean Gotman, from McGill University's Montreal Neurological Institute, and his colleagues lead to improved treatment of patients suffering from epilepsy. The combination ...
41 minutes ago | not rated yet | 0
Studying the networks of connections in the brains of people affected by schizophrenia, bipolar disease or depression has allowed Dr. Peter Williamson, from Western University, to gain a better understanding of the biological ...
39 minutes ago | not rated yet | 0
(Medical Xpress)—Scientists from the Joint Center for Structural Genomics (JCSG) at SLAC National Accelerator Laboratory have determined the 3-D structure of the chemically active part of an enzyme involved ...
1 hour ago | not rated yet | 0 |