ArticleJournal of orthopaedic surgery and research2016
The effect of cumulative glycemic burden on the incidence of diabetic foot disease.
Article in Journal of orthopaedic surgery and research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 4 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 4 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Effectiveness and safety of stem cell therapy for diabetic foot: a meta-analysis update.Stem cell research & therapy · 2022Pooled it
- Risk factors for diabetic foot complications in type 2 diabetes-A systematic review.Endocrinology, diabetes & metabolism · 2021Pooled it
- Therapeutic inertia in the treatment of hyperglycaemia in patients with type 2 diabetes: A systematic review.Diabetes, obesity & metabolism · 2018 · on this mapPooled it
- Meta-analysis on the treatment of diabetic foot ulcers with autologous stem cells.Stem cell research & therapy · 2017Pooled it
- Overexpression of hsa-HLA-DRB1 may delay diabetic wound healing and angiogenesis by regulating miRNA_12118 and FLT-1.Scientific reports · 2025Article
- The causal relationship between gut microbiota and diabetic neuropathy: a bi-directional two-sample Mendelian randomization study.Frontiers in endocrinology · 2024Article
- Article
- Isolation and characterization of bacteria from diabetic foot ulcer: amputation, antibiotic resistance and mortality rate.International journal of diabetes in developing countries · 2022Article
- Diabetic foot complications-lessons learned from real-world data derived from a specialized Austrian hospital.Wiener klinische Wochenschrift · 2022Article
- Article
- Risk factors for diabetic foot complications among patients with type 2 diabetes in Austria-A registry-based retrospective cohort study.Endocrinology, diabetes & metabolism · 2021Article
- Modified tibial transverse transport technique for the treatment of ischemic diabetic foot ulcer in patients with type 2 diabetes.Journal of orthopaedic translation · 2021Article
- A Patient-Level Model to Estimate Lifetime Health Outcomes of Patients With Type 1 Diabetes.Diabetes care · 2020Article
- Understanding Metabolic Memory: A Tale of Two Studies.Diabetes · 2020Review
- Fasting plasma glucose variability and HbA1c are associated with peripheral artery disease risk in type 2 diabetes.Cardiovascular diabetology · 2020Observational
- Article
- Nanofiber-expanded human CD34Scientific reports · 2019Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundGlycemic control is a known modifiable risk factor for diabetic foot disease. Prior attempts to define its relationship with diabetic foot ulcer and Charcot arthropathy fail to account for variability in control and duration of diabetic disease. We developed a novel metric to reflect aggregate disease exposure in a diabetic, termed cumulative glycemic burden. We hypothesized that it would be positively associated with both diabetic foot ulcer and radiographically diagnosed Charcot arthropathy.
methodsPatients aged 18 to 90 years with ≥3 hemoglobin A1c (HbA1c) values were identified retrospectively at a single institution over a 15-year period. Primary outcomes were ICD-9 diagnosis of foot ulcer and radiographically diagnosed Charcot arthropathy. Cumulative glycemic burden was calculated by trapezoidal integration of the area under a curve defined by HbA1c values above 7 over time. Patients were stratified into quartiles based on cumulative glycemic burden (excellent, good, fair, and poor control). χ
resultsOut of 22,913 diabetics, 1643 (7.2%) had a foot ulcer; 54 out of 771 diabetics (7.0%) had radiographic Charcot arthropathy. There was a statistically significant stepwise increase in the incidence of foot ulcer with increasing cumulative glycemic burden by patient quartile (5.2 vs. 6.4 vs. 7.9 vs. 13.9%; P < .001). No significant trend was seen between incidence of Charcot arthropathy and greater cumulative glycemic burden (7.8 vs. 5.6 vs. 4.4 vs. 10.0%; P = .469). Peripheral vascular disease was most strongly associated with diabetic foot ulcer. Hypertension and diabetic neuropathy were independently associated with Charcot arthropathy.
conclusionsIncreasing cumulative glycemic burden is positively associated with diabetic foot ulcer. Greater attention should be paid towards the most poorly controlled diabetics with the longest duration of disease to reduce their risk. Cumulative glycemic burden is not associated with Charcot arthropathy.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.