Factors associated with the recurrence of foot ulcers in Japanese patients with diabetes.

IF 1.2 Q4 ENDOCRINOLOGY & METABOLISM

Diabetology International Pub Date : 2024-11-07 eCollection Date: 2025-01-01 DOI:10.1007/s13340-024-00768-9

Kou Ino, Yuji Tajiri, Hisashi Migita, Keigo Morinaga, Hideaki Rikimaru, Kensuke Kiyokawa

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Abstract

Aim: Patients with diabetes are frequently complicated with diabetic foot ulcers (DFUs) which are vulnerable to recurrence after healing. We retrospectively surveyed the recurrence of foot ulcer and related factors in Japanese patients with DFUs.

Subjects and methods: Forty-two feet of 39 patients were initially recruited in this study. During the follow-up period, the recurrence of foot ulcers was observed in nine feet. Peak planter pressure (PPP) distribution on the affected side was measured at three pressure levels. Photographs of the plantar scar were superimposed on the high-pressure plantar area, and the concordance of both lesions was counted.

Results: The recurrence of foot ulcer was significantly related to higher body weight, a history of discontinued or unused insole, the existence of scar at the sole concomitant with load, and longer observation period. The existence of scar was further selected as a significant predictive variable in multiple logistic regression analysis. Furthermore, the recurrence rate significantly increased in parallel with the increment of the concordance rate at 250 kPa or more level of pressure (P = 0.0199, odds ratio = 22.054).

Conclusions: For the prevention of the recurrence of foot ulcers, education on the continuous use of insole and adequate treatments of scar at the sole, concomitant with load especially in patients with higher body weight and longer observation period, is required. It is plausible that the concordance of PPP and scar lesions properly predicts the recurrences of foot ulcers, which may help to avoid unnecessary amputations in the future in Japanese patients with diabetes.

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日本糖尿病患者足部溃疡复发的相关因素

目的：糖尿病患者常并发糖尿病足溃疡（DFUs），其愈合后易复发。我们回顾性调查了日本足部溃疡患者的复发及相关因素。研究对象和方法：本研究最初招募了39名患者中的42名。在随访期间，有9只脚溃疡复发。在三个压力水平下测量了受影响侧的峰值播种机压力（PPP）分布。足底疤痕的照片叠加在高压足底区，并计算两个病变的一致性。结果：足部溃疡的复发与体重较高、鞋底停用或未使用、鞋底伴随负重存在疤痕、观察时间较长等因素有显著关系。在多元logistic回归分析中，进一步选择疤痕的存在作为显著的预测变量。在250 kPa及以上压力水平下，复发率随一致性率的增加而显著增加（P = 0.0199，优势比为22.054）。结论：预防足部溃疡复发，尤其对体重较高、观察期较长的患者，需要进行持续使用鞋垫的教育和足部瘢痕的适当治疗，并伴有负荷。PPP和疤痕病变的一致性可以正确预测足部溃疡的复发，这可能有助于避免未来日本糖尿病患者不必要的截肢。

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

Diabetology International ENDOCRINOLOGY & METABOLISM-

CiteScore

3.90

自引率

4.50%

发文量

期刊介绍： Diabetology International, the official journal of the Japan Diabetes Society, publishes original research articles about experimental research and clinical studies in diabetes and related areas. The journal also presents editorials, reviews, commentaries, reports of expert committees, and case reports on any aspect of diabetes. Diabetology International welcomes submissions from researchers, clinicians, and health professionals throughout the world who are interested in research, treatment, and care of patients with diabetes. All manuscripts are peer-reviewed to assure that high-quality information in the field of diabetes is made available to readers. Manuscripts are reviewed with due respect for the author''s confidentiality. At the same time, reviewers also have rights to confidentiality, which are respected by the editors. The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.