Delayed treatment of diabetic foot ulcer in patients with type 2 diabetes and its prediction model.

IF 4.2 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

World Journal of Diabetes Pub Date : 2024-10-15 DOI:10.4239/wjd.v15.i10.2070

Hui Chen, Ying Xi

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引用次数: 0

Abstract

Background: Diabetic foot (DF) is a serious complication of type 2 diabetes. This study aimed to investigate the factors associated with DF occurrence and the role of delayed medical care in a cohort of patients with type 2 diabetes.

Aim: To reveal the impact of delayed medical treatment on the development of DF in patients with type 2 diabetes and to establish a predictive model for DF.

Methods: In this retrospective cohort study, 292 patients with type 2 diabetes who underwent examination at our hospital from January 2023 to December 2023 were selected and divided into the DF group (n = 82, DF) and nondiabetic foot group (n = 210, NDF). Differential and correlation analyses of demographic indicators, laboratory parameters, and delayed medical treatment were conducted for the two groups. Logistic regression was applied to determine influencing factors. Receiver operating characteristic (ROC) analysis was performed, and indicators with good predictive value were selected to establish a combined predictive model.

Results: The DF group had significantly higher body mass index (BMI) (P < 0.001), disease duration (P = 0.012), plasma glucose levels (P < 0.001), and HbA1c (P < 0.001) than the NDF group. The NDF group had significantly higher Acute Thrombosis and Myocardial Infarction Health Service System (ATMHSS) scores (P < 0.001) and a significantly lower delayed medical treatment rate (72.38% vs 13.41%, P < 0.001). BMI, duration of diabetes, plasma glucose levels, HbA1c, diabetic peripheral neuropathy, and nephropathy were all positively correlated with DF occurrence. ATMHSS scores were negatively correlated with delayed time to seek medical treatment. The logistic regression model revealed that BMI, duration of diabetes, plasma glucose levels, HbA1c, presence of diabetic peripheral neuropathy and nephropathy, ATMHSS scores, and delayed time to seek medical treatment were influencing factors for DF. ROC analysis indicated that plasma glucose levels, HbA1c, and delayed medical treatment had good predictive value with an area under the curve of 0.933 for the combined predictive model.

Conclusion: Delayed medical treatment significantly affects the probability of DF occurrence in patients with diabetes. Plasma glucose levels, HbA1c levels, and the combined predictive model of delayed medical treatment demonstrate good predictive value.

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2 型糖尿病患者糖尿病足溃疡的延迟治疗及其预测模型。

背景：糖尿病足（DF）是2型糖尿病的一种严重并发症。目的：揭示延迟治疗对 2 型糖尿病患者糖尿病足发生的影响，并建立糖尿病足的预测模型：在这项回顾性队列研究中，选取了 2023 年 1 月至 2023 年 12 月期间在我院接受检查的 292 例 2 型糖尿病患者，将其分为 DF 组（n = 82，DF）和非糖尿病足组（n = 210，NDF）。对两组患者的人口统计学指标、实验室参数和延迟治疗进行了差异和相关分析。应用 Logistic 回归确定影响因素。进行受体操作特征（ROC）分析，选择预测价值高的指标建立综合预测模型：结果：DF 组的体重指数（BMI）（P < 0.001）、病程（P = 0.012）、血浆葡萄糖水平（P < 0.001）和 HbA1c（P < 0.001）均明显高于 NDF 组。NDF组的急性血栓形成和心肌梗死健康服务系统（ATMHSS）评分明显高于NDF组（P < 0.001），延迟医疗率明显低于NDF组（72.38% vs 13.41%，P < 0.001）。体重指数、糖尿病病程、血浆葡萄糖水平、HbA1c、糖尿病周围神经病变和肾病均与 DF 的发生呈正相关。ATMHSS 评分与延迟就医时间呈负相关。逻辑回归模型显示，体重指数、糖尿病病程、血浆葡萄糖水平、HbA1c、是否存在糖尿病周围神经病变和肾病、ATMHSS 评分和延迟就医时间是 DF 的影响因素。ROC分析表明，血浆葡萄糖水平、HbA1c和延迟就医具有良好的预测价值，综合预测模型的曲线下面积为0.933：结论：延迟治疗会明显影响糖尿病患者发生 DF 的概率。血浆葡萄糖水平、HbA1c 水平和延迟医疗的综合预测模型都具有良好的预测价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.