ArticleEndocrinology and metabolism (Seoul, Korea)2025
The Severity of Diabetes and the Risk of Diabetic Foot Amputation: A National Cohort Study.
Article in Endocrinology and metabolism (Seoul, Korea), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Diabetes progression and severe hypoglycemia: a nationwide cohort study of 2,475,605 adults with type 2 diabetes mellitus.The Korean journal of internal medicine · 2026Article
- Diabetes progression and its association with fracture risk in type 2 diabetes.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Nationwide Big Data Studies of Endocrine Diseases Using the Korean National Health Information Database: Research Trends and Standardization of Operational Definitions.Endocrinology and metabolism (Seoul, Korea) · 2026Review
- Deep learning-derived retinal biomarker associated with diabetes-related amputation in type 2 diabetes.Frontiers in endocrinology · 2026Observational
- Hemoglobin-albumin-lymphocyte-platelet score associated with diabetic foot severity, unlike modified systemic immune-inflammatory index and modified systemic inflammatory response index.Frontiers in endocrinology · 2026Article
- Association of high-density lipoprotein-related inflammatory indicators with diabetic foot ulcer in patients with diabetes: a population-based study.Diabetology & metabolic syndrome · 2025Article
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Authors and funding
6 authors.
Funding
Abstract
backgruoundThis study aimed to assess whether markers of diabetes severity could serve as predictors for foot amputation risk among patients with type 2 diabetes mellitus.
methodsWe analyzed data from the nationally representative Korean National Health Insurance System database, tracking 2,544,077 patients with type 2 diabetes mellitus who participated in routine health check-ups between 2009 and 2012, with followup extending through the end of 2018. The parameters used to define the diabetes severity score encompassed diabetes duration, insulin usage, the number of oral glucose-lowering medications, the presence of chronic kidney disease, diabetic retinopathy, and cardiovascular disease. Each factor was assigned one point, yielding a cumulative severity score ranging from 0 to 6.
resultsThe risk of diabetic foot amputation was predominantly predicted by insulin therapy, diabetic retinopathy, and a prolonged duration of diabetes. The hazard ratios for foot amputation increased with the severity score as follows: 2.31 (95% confidence interval [CI], 2.15 to 2.47) for a score of 1, 4.73 (95% CI, 4.42 to 5.07) for a score of 2, 8.86 (95% CI, 8.24 to 9.53) for a score of 3, 16.95 (95% CI, 15.60 to 18.4) for a score of 4, 23.98 (95% CI, 21.25 to 27.05) for a score of 5, and 37.87 (95% CI, 28.93 to 49.57) for a score of 6.
conclusionSpecific markers of advanced diabetes effectively identified patients at an elevated risk for diabetic foot amputation.
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