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Association between diabetic foot ulcers and death in the UK

The presence of diabetic foot ulcers is known to be associated with an increased risk of death. In a recently published study, the authors sought to investigate whether the effects of other diabetes-associated complications could explain the relationship between diabetic foot ulcers and death. They found that the increased risk of death cannot be fully explained by the other complications, which provides evidence of a strong independent link between foot ulcers and mortality.

By Colin Kenny, GP, Dromore


The investigators analysed data from 414,523 people with diabetes enrolled in practices linked to The Health Improvement Network in the UK. Their study was designed to control for any potential confounders in order to isolate the relationship between diabetic foot ulcers and mortality.

Among the cohort, 20,737 developed diabetic foot ulcers. Of the people with new ulcers, 5.0% died within 12 months of their first ulcer-related visit, while 42.2% of people with foot ulcers died within 5 years. After controlling for major known complications of diabetes that might have an influence on mortality, the correlation between diabetic foot ulcers and death remained strong with a fully adjusted hazard ratio of 2.48.

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