Evidence mapPaperPMID 38403299Full record

ArticleJournal of diabetes2024

Factors associated with diabetic foot ulcers and lower limb amputations in type 1 and type 2 diabetes supported by real-world data from the German/Austrian DPV registry.

Alexander J Eckert, Stefan Zimny, Marcus Altmeier, Ana Dugic, Anton Gillessen, Latife Bozkurt, Gabriele Götz, Wolfram Karges, Frank J Wosch, Stephan Kress and 2 more

Open access · goldAbstract read
In one paragraph

Article in Journal of diabetes, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 3 pooled it
5.4field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 15 citations in OpenAlex.

  1. Pooled it
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  8. Observational
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  13. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 8 institutions in 2 countries.

Alexander J EckertInstitute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.ORCID https://orcid.org/0000-0003-1239-3078
Stefan ZimnyDepartment of General Internal Medicine, Endocrinology and Diabetology, Helios Clinic Schwerin, Schwerin, Germany.
Marcus AltmeierKlinik für Diabetologie, Klinikum Dortmund, Dortmund, Deutschland.
Ana DugicMedical Clinic I, Klinikum Bayreuth Friedrich-Alexander-University Erlangen-Nürnberg, Bayreuth, Germany.
Anton GillessenDepartment of Internal Medicine, Herz-Jesu-Hospital, Muenster, Germany.
Latife BozkurtDepartment of Internal Medicine III and Karl Landsteiner Institute for Metabolic Disorders and Nephrology, Clinic Hietzing, Vienna Health Care Group, Vienna, Austria.
Gabriele GötzDepartment of Internal Medicine, Diabetes, Gastroenterology, Tumor Medicine, and Palliative Care, Academic Teaching Hospital Nürtingen, Tübingen, Germany.
Wolfram KargesClinic for Gastroenterology, Metabolic Disorders and Internal Intensive Medicine (Medical Clinic III), Department of Endocrinology and Diabetology, University Hospital Aachen, Aachen, Germany.
Frank J WoschDiabetespraxis Wosch, Hanau, Germany.
Stephan KressDiabetes, Sport and Physical Activity Working Group of the DDG, Unna, Germany.
Reinhard W HollInstitute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.
DPV-Wiss-Initiative
Universität Ulm · DEFriedrich-Alexander-Universität Erlangen-Nürnberg · DEHelios Hospital Schwerin · DEKlinik Hietzing · ATKlinikum Dortmund · DEKlinikum Hanau · DEUniversitätsklinikum Aachen · DEUniversity of Koblenz and Landau · DE

Funding

Deutsche Diabetes GesellschaftGerman Robert Koch Institute (RKI)the German Federal Ministry for Education and Research within the German Centre for Diabetes Research 82DZD14E03
6 · The paper itself

Abstract

aimsDiabetic foot ulcer (DFU) is a leading cause of lower limb amputations in people with diabetes. This study was aimed to retrospectively analyze factors affecting DFU using real-world data from a large, prospective central-European diabetes registry (DPV [Diabetes-Patienten-Verlaufsdokumentation]). MATERIALS AND

methodsWe matched adults with type 1 (T1D) or type 2 diabetes (T2D) and DFU to controls without DFU by diabetes type, age, sex, diabetes duration, and treatment year to compare possible risk factors. Cox regression was used to calculate hazard ratios for amputation among those with DFU.

resultsIn our cohort (N = 63 464), male sex, taller height, and diabetes complications such as neuropathy, peripheral artery disease, nephropathy, and retinopathy were associated with DFU (all p < .001). Glycated hemoglobin (HbA1c) was related to DFU only in T1D (mean with 95% confidence interval [CI]: 7.8 [6.9-9.0] % vs 7.5 [6.8-8.5] %, p < .001). High triglycerides and worse low-density lipoprotein/high-density lipoprotein ratio were also associated with DFU in T1D, whereas smoking (14.7% vs 13.1%) and alcohol abuse (6.4% vs 3.8%, both p < .001) were associated with DFU in T2D. Male sex, higher Wagner grades, and high HbA1c in both diabetes types and insulin use in T2D were associated with increased hazard ratios for amputations.

conclusionsSex, body height, and diabetes complications were associated DFU risk in adults with T1D and T2D. Improvement in glycemic control and lipid levels in T1D and reduction of smoking and drinking in T2D may be appropriate interventions to reduce the risk for DFU or amputations.

Indexed as

Diabetes Mellitus, Type 1Diabetes Mellitus, Type 2Diabetic FootAdultAmputation, SurgicalAustriaGlycated HemoglobinHumansLower ExtremityMaleProspective StudiesRegistriesRetrospective StudiesRisk FactorsGlycated Hemoglobinalcoholbody mass indexhypertensionlipidssex differencessmokingtriglycerides

Identifiers

PMID38403299
PMCPMC10894714
OpenAlexW4392148037

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.