Impact of Poor Glycemic Control and Vascular Complications on Diabetic Foot Ulcer Recurrence
Alva C. Mustamu 1*, Elisabeth Samaran 1, Difran Nobel Bistara 1
Journal of Angiotherapy 8(8) 1-6 https://doi.org/10.25163/angiotherapy.889854
Submitted: 20 May 2024 Revised: 05 August 2024 Published: 11 August 2024
This study identifies key risk factors of glycemic control, vascular issues, and behaviors driving diabetic foot ulcer recurrence in Sorong
Abstract
Background: Diabetes mellitus is a growing global health issue that leads to serious complications like diabetic foot ulcers (DFUs), which can worsen health and increase death rates in diabetic patients. In Sorong, Southwest Papua, Indonesia, the recurrence of DFUs is a major public health problem, affecting patients' well-being and adding significant healthcare costs. This study aimed to identify the factors that contribute to DFU recurrence in this region to help improve prevention and treatment strategies. Methods: A cross-sectional study was conducted in Sorong, Indonesia, including 53 diabetic patients with recurrent DFUs. Data were collected through structured interviews, physical examinations, and laboratory tests. Risk factors such as metabolic, vascular, behavioral, and demographic elements were analyzed. Statistical analysis, including univariate, bivariate, and multivariate techniques, was performed to identify independent predictors of DFU recurrence. Results: The study found that poor glycemic control, with a mean HbA1c of 8.3±1.4, and vascular complications, such as peripheral artery disease and neuropathy, were the most significant predictors of DFU recurrence. Behavioral factors like smoking and physical inactivity, along with longer diabetes duration and previous ulcer history, also showed a strong correlation with recurrence. Logistic regression identified HbA1c levels, peripheral artery disease, and smoking habits as independent predictors. Conclusion: This study determined the need for comprehensive care that focuses on controlling blood sugar levels, managing vascular issues, and promoting healthy behaviors to prevent diabetic foot ulcer recurrence in Sorong, Southwest Papua. Future efforts should target these risk factors to lower recurrence rates and improve patient health. More research is needed to find effective ways to prevent DFU recurrence in this population.
Keywords: Diabetic foot ulcer, Recurrence, Glycemic control, Vascular complications, Health behaviors
References
Ababneh, A., Finlayson, K., Edwards, H., & Lazzarini, P. A. (2022). Factors associated with adherence to using removable cast walker treatment among patients with diabetes-related foot ulcers. BMJ Open Diabetes Research & Care, 10(2), Article e002640. https://doi.org/10.1136/bmjdrc-2021-002640
Andrikopoulou, E., Chatzistergos, P., & Chockalingam, N. (2024). Exploring the pathways of diabetes foot complications treatment and investigating experiences from frontline health care professionals: Protocol for a mixed methods study. JMIR Research Protocols, 13, Article e54852. https://doi.org/10.2196/54852
Baig, M. S., Banu, A., Zehravi, M., et al. (2022). An overview of diabetic foot ulcers and associated problems with special emphasis on treatments with antimicrobials. Life, 12(7), Article 1054. https://doi.org/10.3390/life12071054
Bundó, M., Vlacho, B., Llussà, J., et al. (2023). Prediction of outcomes in subjects with type 2 diabetes and diabetic foot ulcers in Catalonian primary care centers: A multicenter observational study. Journal of Foot and Ankle Research, 16, 8. https://doi.org/10.1186/s13047-023-00602-6
Chen, L., Sun, S., Gao, Y., & Ran, X. (2023). Global mortality of diabetic foot ulcer: A systematic review and meta-analysis of observational studies. Diabetes Obesity and Metabolism, 25(1), 36-45. https://doi.org/10.1111/dom.14840
Choudhury, A. A., & Devi Rajeswari, V. (2021). Gestational diabetes mellitus - A metabolic and reproductive disorder. Biomedicine & Pharmacotherapy, 143, 112-183. https://doi.org/10.1016/j.biopha.2021.112183
Deng, L., Xie, P., Chen, Y., et al. (2022). Impact of acute hyperglycemic crisis episode on survival in individuals with diabetic foot ulcer using a machine learning approach. Frontiers in Endocrinology, 13, 1-10. https://doi.org/10.3389/fendo.2022.974063
Gallagher, K. A., Mills, J. L., Armstrong, D. G., et al. (2024). Current status and principles for the treatment and prevention of diabetic foot ulcers in the cardiovascular patient population: A scientific statement from the American Heart Association. Circulation, 149(3), 232-253. https://doi.org/10.1161/CIR.0000000000001192
Hossain, M. d. J., Al-Mamun, M. d., & Islam, M. d. R. (2024). Diabetes mellitus, the fastest growing global public health concern: Early detection should be focused. Health Sciences Reports, 7, Article e2004. https://doi.org/10.1002/hsr2.2004
Ibrahim, I., Nuermaimaiti, Y., Maimaituxun, G., et al. (2024). Neutrophil extracellular traps (NETs) are associated with type 2 diabetes and diabetic foot ulcer-related amputation: A prospective cohort study. Diabetes Therapy: Research, Treatment, and Education of Diabetes and Related Disorders, 15, 1333-1348. https://doi.org/10.1007/s13300-024-01579-6
Jalilian, M., Ahmadi Sarbarzeh, P., & Oubari, S. (2020). Factors related to severity of diabetic foot ulcer: A systematic review. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 13, 1835-1842. https://doi.org/10.2147/DMSO.S256243
Jeyaraman, K., Berhane, T., Hamilton, M., Chandra, A. P., & Falhammar, H. (2019). Mortality in patients with diabetic foot ulcer: A retrospective study of 513 cases from a single centre in the Northern Territory of Australia. BMC Endocrine Disorders, 19, Article 1. https://doi.org/10.1186/s12902-018-0327-2
Mashili, F., Joachim, A., Aboud, S., et al. (2019). Prospective exploration of the effect of adiposity and associated microbial factors on healing and progression of diabetic foot ulcers in Tanzania: Study protocol of a longitudinal cohort study. BMJ Open, 9, Article e031896. https://doi.org/10.1136/bmjopen-2019-031896
Michalopoulos, A., & Apalla, Z. (2022). Dermatological manifestations of diabetes: A systematic review. Journal of the European Academy of Dermatology and Venereology, 36(3), 347-361. https://doi.org/10.1111/jdv.17911
Ong, K. L., Stafford, L. K., McLaughlin, S. A., et al. (2023). Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: A systematic analysis for the Global Burden of Disease Study 2021. The Lancet, 402(10395), 203-234. https://doi.org/10.1016/S0140-6736(23)01301-6
Popa, A. D., Gavril, R. S., Popa, I. V., et al. (2023). Survival prediction in diabetic foot ulcers: A machine learning approach. Journal of Clinical Medicine, 12, Article 5816. https://doi.org/10.3390/jcm12185816
Rastogi, A., Goyal, G., Kesavan, R., et al. (2020). Long term outcomes after incident diabetic foot ulcer: Multicenter large cohort prospective study (EDI-FOCUS investigators) epidemiology of diabetic foot complications study. Diabetes Research and Clinical Practice, 162, Article 108113. https://doi.org/10.1016/j.diabres.2020.108113
Rubio, J. A., Jiménez, S., & Lázaro-Martínez, J. L. (2020). Mortality in patients with diabetic foot ulcers: Causes, risk factors, and their association with evolution and severity of ulcer. Journal of Clinical Medicine, 9(9), Article 3009. https://doi.org/10.3390/jcm9093009
Ruze, R., Liu, T., Zou, X., et al. (2023). Obesity and type 2 diabetes mellitus: Connections in epidemiology, pathogenesis, and treatments. Frontiers in Endocrinology, 14, Article 1161521. https://doi.org/10.3389/fendo.2023.1161521
The Lancet. (2023). Diabetes: A defining disease of the 21st century. The Lancet, 401(10336), 2087. https://doi.org/10.1016/S0140-6736(23)01296-5
Tola, A., Regassa, L. D., & Ayele, Y. (2021). Prevalence and associated factors of diabetic foot ulcers among type 2 diabetic patients attending chronic follow-up clinics at governmental hospitals of Harari Region, Eastern Ethiopia: A 5-year (2013-2017) retrospective study. SAGE Open Medicine, 9, 1-9. https://doi.org/10.1177/2050312120987385
Tomic, D., Shaw, J. E., & Magliano, D. J. (2022). The burden and risks of emerging complications of diabetes mellitus. Nature Reviews Endocrinology, 18(9), 525-539. https://doi.org/10.1038/s41574-022-00690-7
Waibel, F. W. A., Uçkay, I., Soldevila-Boixader, L., Sydler, C., & Gariani, K. (2024). Current knowledge of morbidities and direct costs related to diabetic foot disorders: A literature review. Frontiers in Endocrinology, 14, Article 10.3389/fendo.2023.1323315. https://doi.org/10.3389/fendo.2023.1323315
Xie, J., Wang, M., Long, Z., et al. (2022). Global burden of type 2 diabetes in adolescents and young adults, 1990-2019: Systematic analysis of the Global Burden of Disease Study 2019. BMJ, 379, Article n072385. https://doi.org/10.1136/bmj-2022-072385
Yu, X., Chen, M., Wu, J., & Song, R. (2024). Research progress of SIRTs activator resveratrol and its derivatives in autoimmune diseases. Frontiers in Immunology, 15, 1-23. https://doi.org/10.3389/fimmu.2024.1390907
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