Chen H, Xi Y. Delayed treatment of diabetic foot ulcer in patients with type 2 diabetes and its prediction model. World J Diabetes 2024; 15(10): 2070-2080 [DOI: 10.4239/wjd.v15.i10.2070]
Corresponding Author of This Article
Ying Xi, BMed, Nurse, Department of General Practice, Shaanxi Provincial People's Hospital, No. 256 Youyi West Road, Xi’an 710000, Shaanxi Province, China. 18092488824@163.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Oct 15, 2024; 15(10): 2070-2080 Published online Oct 15, 2024. doi: 10.4239/wjd.v15.i10.2070
Delayed treatment of diabetic foot ulcer in patients with type 2 diabetes and its prediction model
Hui Chen, Ying Xi
Hui Chen, Ying Xi, Department of General Practice, Shaanxi Provincial People's Hospital, Xi’an 710000, Shaanxi Province, China
Author contributions: Chen H designed the experiments and conducted clinical data collection; Xi Y performed postoperative follow-up and recorded the data; Chen H and Xi Y conducted the collation and statistical analysis, wrote the original manuscript and revised the paper; Both authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the institutional Review Board and Ethics Committee of Shaanxi Provincial People's Hospital.
Informed consent statement: The ethics committee agrees to waive informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ying Xi, BMed, Nurse, Department of General Practice, Shaanxi Provincial People's Hospital, No. 256 Youyi West Road, Xi’an 710000, Shaanxi Province, China. 18092488824@163.com
Received: July 23, 2024 Revised: August 19, 2024 Accepted: September 2, 2024 Published online: October 15, 2024 Processing time: 64 Days and 20.5 Hours
Abstract
BACKGROUND
Diabetic foot (DF) is a serious complication of type 2 diabetes. This study aimed to investigate the factors associated with DF occurrence and the role of delayed medical care in a cohort of patients with type 2 diabetes.
AIM
To reveal the impact of delayed medical treatment on the development of DF in patients with type 2 diabetes and to establish a predictive model for DF.
METHODS
In this retrospective cohort study, 292 patients with type 2 diabetes who underwent examination at our hospital from January 2023 to December 2023 were selected and divided into the DF group (n = 82, DF) and nondiabetic foot group (n = 210, NDF). Differential and correlation analyses of demographic indicators, laboratory parameters, and delayed medical treatment were conducted for the two groups. Logistic regression was applied to determine influencing factors. Receiver operating characteristic (ROC) analysis was performed, and indicators with good predictive value were selected to establish a combined predictive model.
RESULTS
The DF group had significantly higher body mass index (BMI) (P < 0.001), disease duration (P = 0.012), plasma glucose levels (P < 0.001), and HbA1c (P < 0.001) than the NDF group. The NDF group had significantly higher Acute Thrombosis and Myocardial Infarction Health Service System (ATMHSS) scores (P < 0.001) and a significantly lower delayed medical treatment rate (72.38% vs 13.41%, P < 0.001). BMI, duration of diabetes, plasma glucose levels, HbA1c, diabetic peripheral neuropathy, and nephropathy were all positively correlated with DF occurrence. ATMHSS scores were negatively correlated with delayed time to seek medical treatment. The logistic regression model revealed that BMI, duration of diabetes, plasma glucose levels, HbA1c, presence of diabetic peripheral neuropathy and nephropathy, ATMHSS scores, and delayed time to seek medical treatment were influencing factors for DF. ROC analysis indicated that plasma glucose levels, HbA1c, and delayed medical treatment had good predictive value with an area under the curve of 0.933 for the combined predictive model.
CONCLUSION
Delayed medical treatment significantly affects the probability of DF occurrence in patients with diabetes. Plasma glucose levels, HbA1c levels, and the combined predictive model of delayed medical treatment demonstrate good predictive value.
Core Tip: This retrospective cohort study investigates factors influencing diabetic foot (DF) in type 2 diabetes patients. Key findings highlight that increased body mass index, longer diabetes duration, elevated plasma glucose and HbA1c levels, as well as complications like diabetic neuropathy, are positively associated with DF occurrence. Additionally, a low Attitudes Toward Medical Help Seeking Scale score and delayed medical care over 3 months correlate with DF. These insights underscore the importance of proactive diabetes management and timely medical intervention to prevent DF, with the study's predictive model demonstrating strong diagnostic potential (area under the curve = 0.933).
