History of Foot Ulcer Increases Mortality Among Individuals With Diabetes

Iversen, Marjolein M.; Tell, Grethe S.; Riise, Trond; Hanestad, Berit Rokne; Østbye, Truls; Graue, Marit; Midthjell, Kristian

doi:10.2337/dc09-0651

Cited by 200 publications

(154 citation statements)

References 23 publications

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“…Consistent with our findings, recent data from a large population-based study of diabetes patients with past foot ulceration also found that these patients reported more symptoms of depression than patients without diabetes, but their level of depression symptoms did not differ from diabetes patients who had not had a foot ulcer [12].…”

Section: Introductionsupporting

confidence: 81%

“…Foot ulcers are the most important risk factor for lower-extremity amputations [5,6] and are associated with substantial treatment costs [7]. Moreover, foot ulceration impacts negatively on quality of life [8] and, perhaps most strikingly, diabetes patients with a history of foot ulceration have a twofold increased risk for mortality as compared with those without foot ulcers [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Depression predicts first but not recurrent diabetic foot ulcers

et al. 2010

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Aims/hypothesis This study examined the relationship between symptoms of depression and the development of diabetic foot ulcers. Methods Participants were 333 patients (71% male; mean age 62 years; 73% with type 2 diabetes) with diabetic peripheral neuropathy (DPN), but without peripheral vascular disease (PVD). Severity of DPN and the presence of PVD were assessed by clinical examination. Depression, other diabetes complications and foot self-care were assessed by self-report. Cox regression tested whether depression was an independent predictor of foot ulceration over 18 months, whether this relationship was moderated by foot ulcer history, and whether foot self-care mediated this relationship. Results During follow-up, 63 patients developed a foot ulcer. Those with prior foot ulcers had more than four-fold greater risk of subsequent foot ulceration compared with those without a history of foot ulcer. A significant interaction effect showed that depression was significantly related to the development of first but not recurrent foot ulcers. This relationship was independent of biological risk factors. In the final model, each standard deviation increase in depression symptoms was significantly associated with increased risk of developing first foot ulcers (HR 1.68, 95% CI 1.20-2.35), while foot self-care was associated with lower risk (HR 0.61, 95% CI 0.40-0.94). Foot self-care did not mediate the relationship between depression and foot ulceration. Conclusions/interpretation These data suggest that depression is associated with increased risk of first foot ulcers in DPN patients and that this relationship is independent of biological risk factors and foot self-care. Interventions that target depression and foot self-care before the development of foot ulcers may maximise the likelihood of successful prevention of foot ulceration.

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Section: Introductionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Depression predicts first but not recurrent diabetic foot ulcers

et al. 2010

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“…Diabetic foot ulcers are defined as ulcers below the ankle due to reduced capillary and/or arterial circulation, neuropathy and foot deformities (4). A number of studies show that persons with diabetic foot ulcers report reduced quality of life, that the ulcers contribute to increased morbidity, and are a marker for excess mortality (5,6). In Norway, 400 -500 below-the-knee amputations are performed each year as a result of diabetic foot ulcers (7).…”

Section: Discussionmentioning

confidence: 99%

Diabetiske fotsårteam i norske sykehus

Robberstad¹,

Bentsen²,

Berg³

et al. 2017

Tidsskriftet

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“…• five wounds treated with amnion/chorion showed a 51% mean area reduction from baseline at 3 weeks into treatment of a single application of allograft • dehydrated human amnion/chorion membrane allografts appear to be a safe, effective and easy to use therapy for chronic non-healing wounds ulcer free (2,3). Furthermore, the treatment of chronic wounds can be financially burdensome for patients and health care providers.…”

Section: Key Messagesmentioning

confidence: 99%

Amniotic membrane is a potential regenerative option for chronic non‐healing wounds: a report of five cases receiving dehydrated human amnion/chorion membrane allograft

Mrugala

Sui

Plummer

et al. 2015

International Wound Journal

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Amniotic membrane is a potential regenerative option for chronic non-healing wounds: a report of five cases receiving dehydrated human amnion/chorion membrane allograft. Int Wound J 2016; 13:485-492 Abstract A case series of five patients with a total of six chronic non-healing wounds (>30 day duration) were non-randomly selected to evaluate the performance, safety and handling properties of dehydrated human amnion/chorion membrane allograft, an amniotic membrane scaffolding product. The patients had lower extremity wounds that had previously failed standard of care within a university outpatient/inpatient wound healing programme. Five wounds treated with dehydrated amnion/chorion membrane allograft showed a mean 43% area reduction from baseline (51% median) at 3 weeks into treatment and completely healed with a 64-day median time to closure (SD ±27⋅6 days). One wound worsened at 3 weeks and was found to have a complete central vein obstruction that was treated with long-term mild compression but still eventually healed at 6 months. Removing this outlier, the four responding wounds had a 72% mean and 69% median change in area from baseline, at the 3 week point. All five patients received only one application of dehydrated human amnion/chorion membrane allograft, and there were no adverse events. The product was easy to use, administer and handle. In summary, dehydrated human amnion/chorion membrane allograft appears to be a safe, effective and easy to use therapy for chronic non-healing wounds. This study describes the details of these clinical cases and provides an overview of the current evidence on the use of amniotic tissue in clinical practice.

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History of Foot Ulcer Increases Mortality Among Individuals With Diabetes

Cited by 200 publications

References 23 publications

Depression predicts first but not recurrent diabetic foot ulcers

Depression predicts first but not recurrent diabetic foot ulcers

Diabetiske fotsårteam i norske sykehus

Amniotic membrane is a potential regenerative option for chronic non‐healing wounds: a report of five cases receiving dehydrated human amnion/chorion membrane allograft

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