Evidence mapPaperPMID 41879777Full record

ArticleJournal of diabetes investigation2026

Diabetic foot ulcer-related amputation is associated with twofold increased risk of cardiovascular disease: A Korean National Health Information Database Study.

Jinsun Jang, Bong-Seong Kim, Hye Won Yang, Heejun Son, Dong Yeon Lee, Min Gyu Kyung, Hwan Jun Jae, Saebeom Hur, Sang Wha Kim, Sanghyun Ahn and 2 more

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Article in Journal of diabetes investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Jinsun JangDepartment of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, Republic of Korea.ORCID https://orcid.org/0000-0002-9519-5650
Bong-Seong KimDepartment of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.ORCID https://orcid.org/0000-0002-1022-3553
Hye Won YangDepartment of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, Republic of Korea.ORCID https://orcid.org/0009-0007-3386-2650
Heejun SonDepartment of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, Republic of Korea.ORCID https://orcid.org/0009-0004-0892-2365
Dong Yeon LeeDepartment of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.ORCID https://orcid.org/0000-0001-8233-6285
Min Gyu KyungDepartment of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.ORCID https://orcid.org/0000-0003-4747-2411
Hwan Jun JaeDepartment of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.ORCID https://orcid.org/0000-0002-0328-3400
Saebeom HurDepartment of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.ORCID https://orcid.org/0000-0003-0787-5101
Sang Wha KimDepartment of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.ORCID https://orcid.org/0000-0003-0430-3458
Sanghyun AhnDepartment of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.ORCID https://orcid.org/0000-0003-4308-4788
Kyung-Do Han *Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.ORCID https://orcid.org/0000-0002-6096-1263
Soo Heon Kwak *Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, Republic of Korea.ORCID https://orcid.org/0000-0003-1230-0919

Funding

Korean Diabetes Association (KDA) 2023-285Ministry of Food and Drug Safety (MFDS) 23212MFDS202Ministry of Science and ICT (MSIT) RS-2023-00262002National Health Insurance Service (NHIS)
6 · The paper itself

Abstract

aimsTo quantify the risk of cardiovascular disease (CVD) and all-cause mortality associated with diabetic foot ulcer (DFU)-related amputation using a large-scale, nationally representative cohort. MATERIALS AND

methodsThis longitudinal study included individuals with diabetes who underwent standardized national health checkups between 2009 and 2012, with follow-up data obtained from the Korean National Health Insurance Service claims database. CVD was defined as an incident myocardial infarction or stroke occurring after the index health checkup. Cox proportional hazards models were used to estimate the hazard ratios (HRs) for CVD and mortality in individuals with DFU-related amputation compared with those with diabetes but without amputation.

resultsAmong 1,229,689 individuals with diabetes, 1,486 (0.12%) had a DFU-related amputation at baseline. The median follow-up was 8.2 years in the non-amputation group and 6.7 years in the DFU-related amputation group. People with DFU-related amputation had a significantly higher incidence rate of CVD compared with those without DFU-related amputation (32.6 vs. 11.0 per 1000 person-years) with a HR of 1.9 (95% CI 1.6-2.1). The HRs for myocardial infarction and stroke were 2.2 (95% CI 1.9-2.6) and 1.6 (95% CI 1.4-1.8), respectively. All-cause mortality significantly increased in people with DFU-related amputation compared with those without, with an HR of 2.1 (95% CI 1.9-2.3).

conclusionsIn this nationwide population-based cohort, DFU-related amputation was associated with nearly a twofold increased risk of cardiovascular events and mortality. These findings underscore the importance of comprehensive cardiovascular risk assessment and management in patients with diabetic foot complications.

Indexed as

Amputation, SurgicalCardiovascular DiseasesDiabetic FootAdultAgedDatabases, FactualFemaleFollow-Up StudiesHumansIncidenceLongitudinal StudiesMaleMiddle AgedRepublic of KoreaRisk FactorsAmputationCardiovascular diseaseDiabetic foot ulcer

Identifiers

PMID41879777
PMCPMC13238551

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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.