The Association of HbA1c Variability with 12 Week and 12 Month Outcomes on Diabetes Related Foot Ulcer Healing.

IF 3.8 3区 医学 Q2 Medicine
Diabetes Therapy Pub Date : 2024-10-01 Epub Date: 2024-08-17 DOI:10.1007/s13300-024-01640-4
Georgia Thomason, Catherine Gooday, Ian Nunney, Ketan Dhatariya
{"title":"The Association of HbA<sub>1c</sub> Variability with 12 Week and 12 Month Outcomes on Diabetes Related Foot Ulcer Healing.","authors":"Georgia Thomason, Catherine Gooday, Ian Nunney, Ketan Dhatariya","doi":"10.1007/s13300-024-01640-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to determine the relationship between HbA<sub>1c</sub> variability and foot ulcer healing at 12 weeks and 12 months.</p><p><strong>Methods: </strong>Using National Diabetic Foot Care Audit (NDFA) and hospital records, demographics, baseline ulcer characteristics and healing outcomes for subjects presenting with a foot ulcer between 2017-2022 were collected at 12 weeks and 12 months. Subjects had diabetes duration > 3 years and ≥ 3 HbA<sub>1c</sub> recordings in the 5 years prior to presentation.</p><p><strong>Results: </strong>At 12 weeks, factors associated with an active ulcer were presence on hind foot (adjusted odds ratios) (2.1 [95% CI 1.3-3.7]), ischaemia (2.1 [95% CI:1.4-3.2]), area > 1 cm<sup>2</sup> (2.7 [95% CI:1.7-4.2]) and diabetes duration > 24 years vs 3-10 (AOR 2.0 [95% CI 1.2-3.5]). After adjustment, HbA<sub>1c</sub> variability 6-10 mmol/mol and > 14.5 mmol/mol had AOR of 1.76 (95% CI 1.1-2.8; p = 0.0192) and 1.5 (95% CI 0.9-2.6; p = 0.1148) of an active ulcer at 12 weeks vs variability < 6 mmol/mol. At 12 months, ischaemia (AOR 2.4 [95% CI 1.5-3.8]) and diabetes duration > 24 years vs 3-10 years (AOR 3.3 [95% CI 1.7-6.4] were significant factors. HbA<sub>1c</sub> variability was not significant at 12 months.</p><p><strong>Conclusion: </strong>In keeping with the national NDFA data, in our cohort ulcer characteristics, but not HbA<sub>1c</sub> variability, were the key factors associated with ulcer healing at 12 weeks and 12 months.</p>","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411040/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13300-024-01640-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/17 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: This study aimed to determine the relationship between HbA1c variability and foot ulcer healing at 12 weeks and 12 months.

Methods: Using National Diabetic Foot Care Audit (NDFA) and hospital records, demographics, baseline ulcer characteristics and healing outcomes for subjects presenting with a foot ulcer between 2017-2022 were collected at 12 weeks and 12 months. Subjects had diabetes duration > 3 years and ≥ 3 HbA1c recordings in the 5 years prior to presentation.

Results: At 12 weeks, factors associated with an active ulcer were presence on hind foot (adjusted odds ratios) (2.1 [95% CI 1.3-3.7]), ischaemia (2.1 [95% CI:1.4-3.2]), area > 1 cm2 (2.7 [95% CI:1.7-4.2]) and diabetes duration > 24 years vs 3-10 (AOR 2.0 [95% CI 1.2-3.5]). After adjustment, HbA1c variability 6-10 mmol/mol and > 14.5 mmol/mol had AOR of 1.76 (95% CI 1.1-2.8; p = 0.0192) and 1.5 (95% CI 0.9-2.6; p = 0.1148) of an active ulcer at 12 weeks vs variability < 6 mmol/mol. At 12 months, ischaemia (AOR 2.4 [95% CI 1.5-3.8]) and diabetes duration > 24 years vs 3-10 years (AOR 3.3 [95% CI 1.7-6.4] were significant factors. HbA1c variability was not significant at 12 months.

Conclusion: In keeping with the national NDFA data, in our cohort ulcer characteristics, but not HbA1c variability, were the key factors associated with ulcer healing at 12 weeks and 12 months.

Abstract Image

HbA1c 变异性与糖尿病足溃疡愈合 12 周和 12 个月结果的关系。
简介本研究旨在确定12周和12个月时HbA1c变异性与足部溃疡愈合之间的关系:利用国家糖尿病足护理审计(NDFA)和医院记录,收集2017-2022年间出现足部溃疡的受试者在12周和12个月时的人口统计学、基线溃疡特征和愈合结果。受试者糖尿病病程>3年,发病前5年内HbA1c记录≥3次:12周时,与活动性溃疡相关的因素有:后足(调整后的几率比)(2.1 [95% CI 1.3-3.7])、缺血(2.1 [95% CI:1.4-3.2])、面积大于1平方厘米(2.7 [95% CI:1.7-4.2])和糖尿病病程大于24年与3-10年(AOR 2.0 [95% CI 1.2-3.5])。经调整后,HbA1c 变异性 6-10 mmol/mol 和 > 14.5 mmol/mol 在 12 周时出现活动性溃疡的 AOR 为 1.76 (95% CI 1.1-2.8; p = 0.0192) 和 1.5 (95% CI 0.9-2.6; p = 0.1148) vs 变异性 24 年 vs 3-10 年(AOR 3.3 [95% CI 1.7-6.4] 是显著因素。12个月时的 HbA1c 变异性不显著:结论:与全国 NDFA 数据一致,在我们的队列中,溃疡特征而非 HbA1c 变异是 12 周和 12 个月时溃疡愈合的关键因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Diabetes Therapy
Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.90
自引率
7.90%
发文量
130
审稿时长
6 weeks
期刊介绍: Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信