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Meta analysis: Diabetic foot ulcers increase the risk of death by 145%.

Guide: Diabetic foot is one of the important complications of diabetes, which brings great pain and heavy economic burden to patients. The common clinical manifestations are chronic ulcers, and the main serious ending of the disease is amputation or even death. Studies have shown that the risk of diabetic foot ulcer in people with diabetes is as high as 25%, and the proportion of amputation among these patients accounts for 14%-24%. Recently, a Meta analysis result about diabetic foot ulcers and mortality rates once again reminded us of “prevention of diabetic foot, emphasizing that it is not too much again.”

META analysis: Diabetic foot ulcers have increased significantly due to mortality rate

1. Study description

The purpose of this study is to explore the relationship between diabetic foot ulcers and patients due to mortality. Researchers use Embase, Medline, Cinahl, Psychinfo, and COCHRANE database to retrieve relevant literature. 446,916, the researchers used i^2 to statistics to check the heterogeneity of the literature (0%-50%is no moderate heterogeneity, 50%-100%is large to a very large heterogeneous nature To.

The above 11 studies include 6 European studies, 1 Australian research, 3 Southeast Asian studies, and 1 American research. The follow-up time is 1-10.5 years, and the average follow-up time is 4.97 years. Time ≤ 3 years, 8 studies follow -up time> 3 years.

In terms of baseline characteristics, the average age of participants in the diabetic foot ulcer group is 68.3, which is 64.5 years older than those of patients with non -foot ulcers. 66%of the participants are men, and the average diabetic disease (12.2 years) of the foot ulcer group is greater than the non -diabetic foot ulcer group (7.0 years), and the cerebral vascular disease, hypertension, coronary arteries and hypertrophic leather disease in the foot ulcer group are The prevalence is significantly higher than that of non -foot ulcers (P <0.001), and the prevalence of nephropathy is also significantly higher than that of non -foot ulcers (P <0.05). Among them, the risk of sufficient ulcers in patients with nephropathy is 1.68 times (95%CI 1.63-1.78) for patients with non-kidney disease. The risk of sufficient ulcers in patients with coronary artery disease is 1.58 times (95%CI 1.50-1.68), that is, nephropathy and nephropathy and nephropathy Cardiovascular diseases can cause risk of diabetes patients to increase the risk of suffering from foot ulcers by more than 50%.

2. Research results

Among the 446916 participants, a total of 84,131 deaths occurred, of which the full cause of the foot ulcer group was 2.45 times that of the non-foot ulcer group (RR 2.45, 95%CI 1.85-2.85). For the rough incidence of death, the foot ulcer group was 181.5 cases/1,000 people, and the non -foot ulcer group was 230.8 cases/1,000 people.

In the Asian group analysis, the average follow-up time (≤ 3 years and> 3 years) will not be observed (≤ 3 years and> 3 years) on the results of the research. RR is 2.43 (95%CI 2.27-2.61) and 2.26 (95%(95%) CI 2.13-2.40). The funnel diagram shows that there is no obvious publishing deviation in this META analysis.

This META analysis shows that once foot ulcers occur, the patient’s risk of death will increase by 145%, reminding us to pay attention to diabetic foot! So what are the risk factors and preventive measures of diabetic foot?

Beware of the risk factor that can cause diabetic foot

1. Overall risk factors: Studies have shown that the risk of poor economic conditions and lack of exercise diabetes patients with diabetes is significantly increased; the risk of large amputation and small amputations in male patients is higher than women (1.39 and 1.77 times of women); In addition, the relationship between diabetic complications/complications and complications and diabetic feet are very close.

2. Local risk factors: Local risk factors mainly include the surrounding neuropathy (important risk factors) of diabetic peripherals (important risk factors), diabetic peripheral arterial lesions, amputation (toe) medical history, abnormal bottom pressure, and insufficiency of lower limb vein.

Do a good job of preventing diabetic foot

The prevention of diabetes is the top priority. Generally speaking, it is divided into two aspects: overall prevention and local prevention.

1. Overall prevention: Do a good job of health education for the disease, control of high -risk factors of blood sugar and cardiovascular disease, smoking cessation, and moderate and regular exercise.

2. Local prevention: Check your foot and shoes and socks every day, and do a good job of treatment of 胼胝 and embedded nails, orthopedic treatment of deformity, the treatment of Charcot neurotransmark And monitoring of skin temperature.

<!-2586: Diabetic terminal page

Summary of this article

Meta analysis shows that once foot ulcer occurs, the risk of premature death of diabetic patients has increased significantly (145%). Remind the majority of medical staff and patients that the attention of diabetic foot cannot be relaxed at any time. Disease prevention should start with little bit in daily life. For diabetic patients with risk factors of sufficient diseases, it is recommended The screening of neuropathy, vascular lesions and foot disease, which is of great significance for improving the quality of life, establishing confidence in defeating diseases, and reducing mortality.

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