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  • 1
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    Global mortality of diabetic foot ulcer: A systematic review and meta‐analysis of observational studies
    Wiley ; 2023
    In:  Diabetes, Obesity and Metabolism Vol. 25, No. 1 ( 2023-01), p. 36-45
    Details
    In: Diabetes, Obesity and Metabolism, Wiley, Vol. 25, No. 1 ( 2023-01), p. 36-45
    Abstract: To estimate the long‐term mortality and risk factors in patients with diabetic foot ulcer (DFU). Methods We systematically searched Medline (PubMed), Embase, Scopus, Web of Science, Cochrane Library, China Science and Technology Journal Database (CQVIP), China National Knowledge Infrastructure, the Chinese Biomedical Literature Database (SinoMed) and Wanfang Data from 1 January 2011 to 31 July 2022. All observational studies that reported long‐term mortality of patients with DFU were included. Random effect models were used to pool the reconstructed participant data from Kaplan–Meier curves. The primary outcome was the long‐term survival of patients with DFU. An aggregate data meta‐analysis was also performed. Results We identified 34 studies, with 124 376 participants representing 16 countries, among whom there were 51 386 deaths. Of these, 27 studies with 21 171 patients were included in the Kaplan–Meier‐based meta‐analysis. The estimated Kaplan–Meier‐based survival rates were 86.9% (95% confidence interval [CI] 82.6%‐91.5%) at 1 year, 66.9% (95% CI 59.3%‐75.6%) at 3 years, 50.9% (95% CI 42.0%‐61.7%) at 5 years and 23.1% (95% CI 15.2%‐34.9%) at 10 years. The results of the aggregate data‐based meta‐analysis were similar. Cardiovascular disease and infection were the most common causes of death, accounting for 46.6% (95% CI 33.5%‐59.7%) and 24.8% (95% CI 16.0%‐33.5%), respectively. Patients with older age (per 1 year, hazard ratio [HR] 1.054, 95% CI 1.045‐1.063), peripheral artery disease (HR 1.882, 95% CI 1.592‐2.225), chronic kidney disease (HR 1.535, 95% CI 1.227‐1.919), end‐stage renal disease (HR 3.586, 95% CI 1.333‐9.643), amputation (HR 2.415, 95% CI 1.323‐4.408) and history of cardiovascular disease (HR 1.449, 95% CI 1.276‐1.645) had higher mortality risk. Conclusions This meta‐analysis found that the overall mortality of DFU was high, with nearly 50% mortality within 5 years. Cardiovascular disease and infection were the two leading causes of death.
    Type of Medium: Online Resource
    ISSN: 1462-8902 , 1463-1326
    URL: Issue
    URL: Article
    DOI: 10.1111/dom.v25.1
    DOI: 10.1111/dom.14840
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2004918-3
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  • 2
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    Adaptation and Validation of the Diabetic Foot Ulcer Scale-Short Form Scale for Chinese Diabetic Foot Ulcers Individuals
    MDPI AG ; 2022
    In:  International Journal of Environmental Research and Public Health Vol. 19, No. 21 ( 2022-11-06), p. 14568-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 19, No. 21 ( 2022-11-06), p. 14568-
    Abstract: Background: The quality of life (QoL) of diabetic foot ulcer patients is worse than that of diabetic patients. The Diabetic Foot Ulcer Scale-Short Form (DFS-SF) is a readily available instrument used to evaluate the quality of life of diabetic foot ulcer individuals. The aim of this study was to translate the DFS-SF into Chinese, followed by an evaluation of its validity and reliability. Methods: This study was conducted in two phases. In the first phase, we followed the Brislin’s Translation and Back-translation model to translate the DFS-SF into Mandarin Chinese. In the second phase, we examined the reliability and validity of the Chinese version of the DFS-SF, where the reliability was assessed in terms of Cronbach’s α coefficient, split-half reliability, and test-retest reliability, and validation of the scale was carried out through content validity, structure validity and criterion validity approaches. Results: A total of 208 participants were recruited for our study. The item-level content validity index (I-CVI) of the Chinese version of the Diabetic Foot Ulcer Scale varied from 0.800 to 1.000, the average scale-level content validity index (S-CVI/Ave) was 0.911, and the Cronbach’s α coefficient of the scale was 0.952. Confirmatory factor analysis indicated good structural validity of the scale, with a Comparative Fit Index (CFI) = 0.920 and a root mean square error of approximation (RMSEA) of 0.069 (p 〈 0.001). The criterion-related validity results indicated that the subscales were significantly related to the subscales of the 36-Item Short-Form Health Survey (SF-36), with coefficients ranging from 0.116 to 0.571 (p 〈 0.05). Discussion: The translation and the examination of the scale rigidly followed the golden standard model, and the reliability observed in our study was similar to that of other studies. Furthermore, the validity assessment indicated that the scale structure was reliable. Therefore, the proposed scales may serve as a reliable instrument for the quality of life evaluation in the diabetic foot ulcers population. Conclusion: The adaptation and validation of the Chinese version of the Diabetic Foot Ulcers Scale-Short Form were reliable, and it will be a reliable instrument to evaluate the QoL of Chinese diabetic foot ulcer patients.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph192114568
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2175195-X
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  • 3
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    Refractory wounds induced by normal‐renal calciphylaxis: An under‐recognised calcific arteriolopathy
    Wiley ; 2023
    In:  International Wound Journal Vol. 20, No. 4 ( 2023-04), p. 1262-1275
    Details
    In: International Wound Journal, Wiley, Vol. 20, No. 4 ( 2023-04), p. 1262-1275
    Abstract: Normal‐renal calciphylaxis (NRC) is a devastating calcific vasculopathy characterised by refractory wounds. It is more likely to be misdiagnosed because of the absence of renal insufficiency. Failure to effectively control may lead to rapid deterioration and ultimately death. However, current knowledge of it is still inadequate. Objectives To provide a relatively comprehensive review of NRC. Methods Nine electronic medical databases including PubMed, Web of Science, Embase, the Cochrane Library and so on were searched from inception to April 1, 2022. Articles in which calciphylaxis was diagnosed in patients with normal renal function were included. Results Totally 140 articles were retrieved with 187 patients (median age, 62 years [IQR, 49.63 ~ 75.70 years]; 83.42% female; 84.5% Caucasian). Vitamin K antagonism (43.32%) and diabetes (39.57%) accounted for most of the concomitant factors. Cutaneous presentations were the most common. Pathological confirmation was made in 97.86% of patients with an accuracy of 99.45%. Multidisciplinary therapeutic strategies were usually implemented while the final prognosis was not ideal, with a 6‐month mortality rate of 21.10% and a 1‐year mortality rate of 27.52%. Conclusion NRC is an under‐recognised disease caused by a variety of factors; meanwhile, multidisciplinary efforts are required to inform diagnostic and therapeutic decisions.
    Type of Medium: Online Resource
    ISSN: 1742-4801 , 1742-481X
    URL: Issue
    URL: Article
    DOI: 10.1111/iwj.v20.4
    DOI: 10.1111/iwj.13951
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2152163-3
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  • 4
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    Prevalence and associated factors of hyperuricemia among Chinese patients with diabetes: a cross-sectional study
    SAGE Publications ; 2023
    In:  Therapeutic Advances in Endocrinology and Metabolism Vol. 14 ( 2023-01)
    Details
    In: Therapeutic Advances in Endocrinology and Metabolism, SAGE Publications, Vol. 14 ( 2023-01)
    Abstract: As a part of metabolic syndrome, hyperuricemia has a higher incidence in patients with diabetes than in the general population owing to various underlying factors. Objectives: The objective of the present study was to investigate the prevalence of hyperuricemia among patients with diabetes and identify associated factors. Design: A cross-sectional study. Methods: Herein, we included patients with diabetes managed at nine healthcare centers in Chenghua District, Chengdu, from February 2021 to November 2021. Clinical data, lifestyle habits, and laboratory data were collected to determine the prevalence and factors associated with hyperuricemia. Results: In total, we included 1577 patients with diabetes (males, 50.35%; females, 49.65%). The median serum uric acid level was 337.9 μmol/L, and the prevalence of hyperuricemia in patients with diabetes was 21.24%. The prevalence of hyperuricemia in male patients was significantly higher than in females (29.35% in males versus 13.03% in females, p  〈  0.001). Male patients with obesity ( p = 0.006) or triglyceride (TG) ⩾ 1.7 mmol/L ( p  〈  0.001) had a high risk of developing hyperuricemia, and hyperuricemia was negatively associated with estimated glomerular filtration rate (eGFR) ⩾ 60 mL/min/1.73 m 2 ( p  〈  0.001), glycosylated hemoglobin (HbA1c) ⩾ 7% ( p  〈  0.001), fenofibrate ( p = 0.010), and sodium-glucose cotransporter 2 (SGLT-2) inhibitors ( p = 0.035). Considering females, overweight ( p = 0.004), alanine transaminase (ALT)  〉  40 U/L ( p  〈  0.001), and TG ⩾ 1.7 mmol/L ( p = 0.015) showed a significant positive correlation with hyperuricemia, while eGFR ⩾ 60 mL/min/1.73 m 2 ( p  〈  0.001) was negatively associated with the risk of hyperuricemia. Conclusion: Hyperuricemia is highly prevalent in patients with diabetes, especially in males. In addition to traditionally associated factors, fenofibrate and SGLT-2 inhibitors were also associated with the risk of hyperuricemia. Registration: The study protocol was registered in the Chinese Clinical Trial Registry ( http://www.chictr.org.cn/ ), and the registration number was ChiCTR 2100042742.
    Type of Medium: Online Resource
    ISSN: 2042-0188 , 2042-0196
    URL: Article
    DOI: 10.1177/20420188231198620
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2554822-0
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  • 5
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    Consensus on the application of negative pressure wound therapy of diabetic foot wounds
    Oxford University Press (OUP) ; 2021
    In:  Burns & Trauma Vol. 9 ( 2021-01-01)
    Details
    In: Burns & Trauma, Oxford University Press (OUP), Vol. 9 ( 2021-01-01)
    Abstract: Because China is becoming an aging society, the incidence of diabetes and diabetic foot have been increasing. Diabetic foot has become one of the main health-related killers due to its high disability and mortality rates. Negative pressure wound therapy (NPWT) is one of the most effective techniques for the treatment of diabetic foot wounds and great progress, both in terms of research and its clinical application, has been made in the last 20 years of its development. However, due to the complex pathogenesis and management of diabetic foot, irregular application of NPWT often leads to complications, such as infection, bleeding and necrosis, that seriously affect its treatment outcomes. In 2020, under the leadership of Burns, Trauma and Tissue Repair Committee of the Cross-Straits Medicine Exchange Association, the writing group for ‘Consensus on the application of negative pressure wound therapy of diabetic foot wounds’ was established with the participation of scholars from the specialized areas of burns, endocrinology, vascular surgery, orthopedics and wound repair. Drawing on evidence-based practice suggested by the latest clinical research, this consensus proposes the best clinical practice guidelines for the application and prognostic evaluation of NPWT for diabetic foot. The consensus aims to support the formation of standardized treatment schemes that clinicians can refer to when treating cases of diabetic foot.
    Type of Medium: Online Resource
    ISSN: 2321-3876
    URL: Article
    DOI: 10.1093/burnst/tkab018
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2775996-9
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  • 6
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    Dynamic changes of wound-related miRNAs after application of autologous platelet-rich gel in diabetic wounds
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Chinese Medical Journal Vol. 135, No. 21 ( 2022-12-21), p. 2644-2646
    Details
    In: Chinese Medical Journal, Ovid Technologies (Wolters Kluwer Health), Vol. 135, No. 21 ( 2022-12-21), p. 2644-2646
    Type of Medium: Online Resource
    ISSN: 0366-6999 , 2542-5641
    URL: Article
    DOI: 10.1097/CM9.0000000000002358
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2108782-9
    SSG: 6,25
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  • 7
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    Telemedicine in Chronic Wound Management: Systematic Review And Meta-Analysis
    JMIR Publications Inc. ; 2020
    In:  JMIR mHealth and uHealth Vol. 8, No. 6 ( 2020-6-25), p. e15574-
    Details
    In: JMIR mHealth and uHealth, JMIR Publications Inc., Vol. 8, No. 6 ( 2020-6-25), p. e15574-
    Abstract: Chronic wounds have been a great burden to patients and the health care system. The popularity of the internet and smart devices, such as mobile phones and tablets, has made it possible to adopt telemedicine (TM) to improve the management of chronic wounds. However, studies conducted by different researchers have reported contradictory results on the effect of TM on chronic wound management. Objective The aim of this work was to evaluate the efficacy and safety of TM in chronic wound management. Methods We systematically searched multiple electronic databases (MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials [CENTRAL]) to identify eligible studies published from inception to June 12, 2019. Inclusion criteria were randomized controlled trials (RCTs) and interventional cohort studies that investigated the use of TM in chronic wound management. RCT and observational data were analyzed separately. A meta-analysis and qualitative analysis were conducted to estimate endpoints. Results A total of 6 RCTs and 6 cohort studies including 3913 patients were included. Of these, 4 studies used tablets or mobile phones programmed with apps, such as Skype and specialized interactive systems, whereas the remaining 8 studies used email, telephone, and videoconferencing to facilitate the implementation of TM using a specialized system. Efficacy outcomes in RCTs showed no significant differences in wound healing (hazard ratio [HR] 1.16, 95% CI 0.96-1.39; P=.13), and wound healing around 1 year (risk ratio [RR] 1.05, 95% CI 0.89-1.23; P=.15). Noninferiority criteria of TM were met. A decreased risk of amputation in patients receiving TM was revealed (RR 0.45, 95% CI 0.29-0.71; P=.001). The result of cohort studies showed that TM was more effective than standard care (HR 1.74, 95% CI 1.43-2.12; P 〈 .001), whereas the outcome efficacy RR of wound healing around 1 year (RR 1.21, 95% CI 0.96-1.53; P=.56) and 3 months (RR 1.24, 95% CI 0.47-3.3; P=.67) was not significantly different between TM and standard care. Noninferiority criteria of TM were met for wound healing around 1 year in cohort studies. Conclusions Currently available evidence suggests that TM seems to have similar efficacy and safety, and met noninferiority criteria with conventional standard care of chronic wounds. Large-scale, well-designed RCTs are warranted.
    Type of Medium: Online Resource
    ISSN: 2291-5222
    URL: Article
    DOI: 10.2196/15574
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2020
    detail.hit.zdb_id: 2719220-9
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  • 8
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    DataSheet_1.docx
    Frontiers Media SA ; 2022
    In:  Frontiers in Endocrinology Vol. 13 ( 2022-5-19)
    Details
    In: Frontiers in Endocrinology, Frontiers Media SA, Vol. 13 ( 2022-5-19)
    Abstract: To investigate the microbial spectrum isolated from foot ulcers among diabetic patients in China, which was conducted to help clinicians choose optimal antibiotics empirically. Method The PubMed, MEDLINE, Web of Science, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), WanFang, and VIP databases were searched for studies published between 2015 to 2019, that report primary data on diabetic foot infection (DFI) and antibiotic susceptibility in China. Result A total of 63 articles about DFI and antibiotic susceptibility tests among diabetic patients in China were included. There were 11,483 patients with an average age of 60.2 ± 10.1 years and a mean course of 10.6 ± 5.0 years between 2010 and 2019, covering most geographical regions of China. The prevalence of Gram-positive (GP) bacteria (43.4%) was lower than that of Gram-negative (GN) (52.4%). The most prevalent pathogens isolated were Staphylococcus aureus (17.7%), Escherichia coli (10.9%), Pseudomonas aeruginosa (10.5%), Klebsiella pneumoniae (6.2%), Staphylococcus epidermidis (5.3%), Enterococcus faecalis (4.9%), and fungus (3.7%). The prevalence of polymicrobial infection was 22.8%. GP bacteria were sensitive to linezolid, vancomycin, and teicoplanin. More than 50% of GN bacteria were resistant to third-generation cephalosporins, while the resistance rates of piperacillin/tazobactam, amikacin, meropenem, and imipenem were relatively low. Among the 6017 strains of the isolated organisms, 20% had multi-drug resistance (MDR). Staphylococcus aureus (30.4%) was the most predominant MDR bacteria, followed by extended-spectrum β-lactamase (ESBL) (19.1%). Conclusion The microbial infection of foot ulcers among diabetic patients in China is diverse. The microbial spectrum is different in different geographic regions and Staphylococcus aureus is the predominant bacteria. Polymicrobial and MDR bacterial infections on the foot ulcers are common. This study could be valuable in guiding the empirical use of antibiotics for diabetic foot infections.
    Type of Medium: Online Resource
    ISSN: 1664-2392
    URL: Article
    URL: Article
    DOI: 10.3389/fendo.2022.881659
    DOI: 10.3389/fendo.2022.881659.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2592084-4
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  • 9
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    Clinical characteristics and risk factors of lower extremity amputation in the diabetic inpatients with foot ulcers
    Frontiers Media SA ; 2023
    In:  Frontiers in Endocrinology Vol. 14 ( 2023-3-31)
    Details
    In: Frontiers in Endocrinology, Frontiers Media SA, Vol. 14 ( 2023-3-31)
    Abstract: To analyze clinical characteristics of the diabetic inpatients with foot ulcers and explore the risk factors of lower extremity amputation (LEA) in West China Hospital of Sichuan University. Methods A retrospective analysis was performed based on the clinical data of the patients with diabetic foot ulcer (DFU) hospitalized in West China Hospital of Sichuan University from January 1, 2012 to December 31, 2020. The DFU patients were divided into three groups: non-amputation, minor amputation, and major amputation groups. The ordinal logistic regression analysis was used to identify the risk factors for LEA. Results 992 diabetic patients (622 males and 370 females) with DFU were hospitalized in the Diabetic Foot Care Center of Sichuan University. Among them, 72 (7.3%) (55 minor amputations and 17 major amputations) cases experienced amputation, and 21(2.1%) refused amputation. Excluding the patients who refused amputation, the mean age and duration of diabetes of and HbA1c the 971 patients with DFU, were 65.1 ± 12.3 years old, 11.1 ± 7.6 years, and 8.6 ± 2.3% respectively. The patients in the major amputation group were older and had longer course of diabetes for a longer period of time than those in the non-amputation and minor amputation groups. Compared with the non-amputation patients (55.1%), more patients with amputation (minor amputation (63.5%) and major amputation (88.2%)) suffered from peripheral arterial disease ( P =0.019). The amputated patients had statistically lower hemoglobin, serum albumin and ankle brachial index (ABI), but higher white blood cell, platelet counts, fibrinogen and C-reactive protein levels. The patients with amputation had a higher incidence of osteomyelitis ( P = 0.006), foot gangrene ( P & lt; 0.001), and a history of prior amputations ( P & lt; 0.001) than those without amputation. Furthermore, a history of prior amputation (odds ratio 10.194; 95% CI , 2.646-39.279; P =0.001), foot gangrene (odds ratio 6.466; 95% CI , 1.576-26.539; P =0.010) and ABI (odds ratio 0.791; 95% CI , 0.639-0.980; P = 0.032) were significantly associated with LEAs. Conclusions The DFU inpatients with amputation were older with long duration of diabetes, poorly glycemic control, malnutrition, PAD, severe foot ulcers with infection. A history of prior amputation, foot gangrene and a low ABI level were the independent predictors of LEA. Multidisciplinary intervention for DFU is essential to avoid amputation of the diabetic patients with foot ulcer.
    Type of Medium: Online Resource
    ISSN: 1664-2392
    URL: Article
    DOI: 10.3389/fendo.2023.1144806
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
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  • 10
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    Exploring the relationship between post-contrast acute kidney injury and different baseline creatinine standards: A retrospective cohort study
    Frontiers Media SA ; 2023
    In:  Frontiers in Endocrinology Vol. 13 ( 2023-1-12)
    Details
    In: Frontiers in Endocrinology, Frontiers Media SA, Vol. 13 ( 2023-1-12)
    Abstract: According to previous studies, the incidence of post-contrast acute kidney injury(PC-AKI) in diabetic is far higher than that in the general population. Therefore, we explored the relationship between the incidence of PC-AKI and different baseline serum creatinine (SCr) levels, and determined the relationship between PC-AKI and different types of contrast media (CMs), different doses of CM, and different examination methods in this specific population. Materials and methods Patients with diabetes in whom CM was used between 2010 and 2020 at our institution were included. Participants were identified according to the following three schemes: Scheme 1 (n=5911), SCr was detected before and within 72 h after using CM; Scheme 2 (n=2385), SCr was detected within 24 h before and within 24–72 h after using CM; and Scheme 3 (n=81), SCr was detected within 24 h before and within 0–24, 24–48, and 48–72 h after using CM. The incidence of PC-AKI with different types of CM, incidence of PC-AKI on digital subtraction angiography (DSA) and enhanced computed tomography (CT), proportion of PC-AKI with different doses of CM, and baseline SCr at different stages of PC-AKI were compared. Multivariate logistic regression analysis was used to explore risk factors for PC-AKI. Results A total of 29,081 patients were included in this study. The incidence of PC-AKI in Scheme 3 (22.22%) was higher than those in Schemes 1 (6.19%) and 2 (7.71%). The incidence of PC-AKI on DSA was higher than that on enhanced CT (8.30% vs. 5.80%; P & lt;0.05). The incidence of PC-AKI in the increased-dose CM group was higher than that in the non-increased-dose CM group (7.9% vs. 5.7%; P & lt;0.01). Moreover, there were differences in baseline SCr values at different stages of PC-AKI ( P & lt;0.01). Multivariate logistic regression analysis showed that hypertension, chronic kidney disease, heart failure, peripheral vascular disease, metformin, diuretics, and CM dose were risk factors for PC-AKI. Conclusion The incidence of PC-AKI increased significantly with increasing time requirement and frequency of SCr detection. Moreover, before using CM, we should control the blood pressure and heart failure, stop using metformin and diuretics, and use CMs at the minimum dose to avoid PC-AKI.
    Type of Medium: Online Resource
    ISSN: 1664-2392
    URL: Article
    DOI: 10.3389/fendo.2022.1042312
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2592084-4
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