Nomogram Prediction for the Risk of Diabetic Foot in Patients With Type 2 Diabetes Mellitus

Wang, Jie; Xue, Ting; Li, Haopeng; Guo, Shaoyun

doi:10.3389/fendo.2022.890057

Cited by 9 publications

(6 citation statements)

References 46 publications

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“…HbA 1c is an independent risk factor for the development of DFUs. [25] Similarly, in a metaanalysis published by Tang et al, HbA 1c level was shown to be one of the factors predicting the development of DFU. [26] The results of the present study revealed a significant correlation between the high HbA 1c values on presentation with the severity of diabetic foot, the surgical procedures applied, and the level of tissue loss present in the patients with diabetic foot.…”

Section: Discussionmentioning

confidence: 88%

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Elevated HbA1c level associated with disease severity and surgical extension in diabetic foot patients

Akyüz

2023

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Diabetic foot is a complex syndrome that is associated with other diabetic complications, such as peripheral arterial disease and peripheral neuropathy. Optimization of plasma glucose and glycated hemoglobin (HbA 1c ) is one of the main principles of standard care and treatment approaches in individuals with diabetes mellitus (DM). In this study, the relationship of HbA 1c level at the time of diagnosis was evaluated with diabetic foot disease severity score and surgical extension in patients with Type 2 DM. METHODS:This study included 301 consecutive patients who were diagnosed with diabetic foot in the general surgery diabetic foot clinic and were hospitalized for surgery. The relationships between the HbA1c levels of the patients with the Wagner and PEDIS (Perfusion, Extent, Dept, Infection, Sensation) classification system grades, and the surgical procedures performed were analyzed and the treatment outcomes were evaluated. RESULTS:It was determined that there was a 90% statistically significant relationship between HbA 1c values of ≥10.1% and the development of Wagner Grade 4 diabetic foot ulcer (DFU) (P=0.037). A strong statistically significant relationship at the rate of 85% was determined between HbA 1c values of ≥10.1% and the development of PEDIS Grade 3 ulcers. As the HbA 1c values increased, so there was determined to be a statistically significant relationship with the development of PEDIS Grade 3 ulcer (P=0.003). In the comparison of the HbA 1c values according to the type of surgery performed, a weak relationship was determined at the rate of 26%, and it was determined that as the HbA 1c values increased, so there could be an increase in the amputation level. CONCLUSION:The results of this study showed that as HbA 1c values at diagnosis increased in patients with diabetic foot; Wagner/ PEDIS grades, disease severity, surgical extension, amputation level, and tissue loss increased. To reduce the severity of diabetic foot disease and prevent amputation, compliance with diabetic treatment and glycemic control should be increased.

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Section: Discussionmentioning

confidence: 88%

“…HbA 1c is an independent risk factor for the development of DFUs. [ 25 ] Similarly, in a meta-analysis published by Tang et al, HbA 1c level was shown to be one of the factors predicting the development of DFU. [ 26 ]…”

Section: Discussionmentioning

confidence: 96%

Elevated HbA1c level associated with disease severity and surgical extension in diabetic foot patients

Akyüz

2023

Ulus Travma Acil Cerrahi Derg

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“…For diabetic patients, leg ulceration is the main cause of lower limb amputation. DM is also responsible for the majority of non-traumatic amputations, 85% of which are predisposed by foot ulceration [78][79][80]. The occurrence of ulcers in diabetic patients is accompanied by a high rate of morbidity and mortality, and also represents an economic and social burden through its implications for functional status and quality of life [81].…”

Section: Diabetic Foot Syndromementioning

confidence: 99%

Old and Novel Predictors for Cardiovascular Risk in Diabetic Foot Syndrome—A Narrative Review

et al. 2023

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Diabetic foot syndrome (DFS) is a complication associated with diabetes that has a strong negative impact, both medically and socio-economically. Recent epidemiological data show that one in six patients with diabetes will develop an ulcer in their lifetime. Vascular complications associated with diabetic foot have multiple prognostic implications in addition to limiting functional status and leading to decreased quality of life for these patients. We searched the electronic databases of PubMed, MEDLINE and EMBASE for studies that evaluated the role of DFS as a cardiovascular risk factor through the pathophysiological mechanisms involved, in particular the inflammatory ones and the associated metabolic changes. In the era of evidence-based medicine, the management of these cases in multidisciplinary teams of “cardio-diabetologists” prevents the occurrence of long-term disabling complications and has prognostic value for cardiovascular morbidity and mortality among diabetic patients. Identifying artificial-intelligence-based cardiovascular risk prediction models or conducting extensive clinical trials on gene therapy or potential therapeutic targets promoted by in vitro studies represent future research directions with a modulating role on the risk of morbidity and mortality in patients with DFS.

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“…At present, the gold standard for the diagnosis of diabetic peripheral neuropathy is nerve conduction studies; however, these are labor-intensive, time-consuming, expensive, and impractical ( 29 ). Diagnosing diabetic foot requires examination of both lower limb arteries and foot and ankle orthopedic examination by color Doppler ultrasound, which is time-consuming and costly ( 30 ). Therefore, it is difficult to obtain comprehensive prediction indicators.…”

Section: Introductionmentioning

confidence: 99%

A risk prediction model for type 2 diabetes mellitus complicated with retinopathy based on machine learning and its application in health management

et al. 2023

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ObjectiveThis study aimed to establish a risk prediction model for diabetic retinopathy (DR) in the Chinese type 2 diabetes mellitus (T2DM) population using few inspection indicators and to propose suggestions for chronic disease management.MethodsThis multi-centered retrospective cross-sectional study was conducted among 2,385 patients with T2DM. The predictors of the training set were, respectively, screened by extreme gradient boosting (XGBoost), a random forest recursive feature elimination (RF-RFE) algorithm, a backpropagation neural network (BPNN), and a least absolute shrinkage selection operator (LASSO) model. Model I, a prediction model, was established through multivariable logistic regression analysis based on the predictors repeated ≥3 times in the four screening methods. Logistic regression Model II built on the predictive factors in the previously released DR risk study was introduced into our current study to evaluate the model’s effectiveness. Nine evaluation indicators were used to compare the performance of the two prediction models, including the area under the receiver operating characteristic curve (AUROC), accuracy, precision, recall, F1 score, balanced accuracy, calibration curve, Hosmer-Lemeshow test, and Net Reclassification Index (NRI).ResultsWhen including predictors, such as glycosylated hemoglobin A1c, disease course, postprandial blood glucose, age, systolic blood pressure, and albumin/urine creatinine ratio, multivariable logistic regression Model I demonstrated a better prediction ability than Model II. Model I revealed the highest AUROC (0.703), accuracy (0.796), precision (0.571), recall (0.035), F1 score (0.066), Hosmer-Lemeshow test (0.887), NRI (0.004), and balanced accuracy (0.514).ConclusionWe have built an accurate DR risk prediction model with fewer indicators for patients with T2DM. It can be used to predict the individualized risk of DR in China effectively. In addition, the model can provide powerful auxiliary technical support for the clinical and health management of patients with diabetes comorbidities.

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Nomogram Prediction for the Risk of Diabetic Foot in Patients With Type 2 Diabetes Mellitus

Cited by 9 publications

References 46 publications

Elevated HbA1c level associated with disease severity and surgical extension in diabetic foot patients

Elevated HbA1c level associated with disease severity and surgical extension in diabetic foot patients

Old and Novel Predictors for Cardiovascular Risk in Diabetic Foot Syndrome—A Narrative Review

A risk prediction model for type 2 diabetes mellitus complicated with retinopathy based on machine learning and its application in health management

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