PMID- 37416023
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230718
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 6
DP  - 2023 Jun
TI  - Predictive Factors for Lower Limb Amputation in Type 2 Diabetics.
PG  - e39987
LID - 10.7759/cureus.39987 [doi]
LID - e39987
AB  - INTRODUCTION: Type 2 diabetes mellitus (T2DM) is a major public health 
      problem. Foot-related complications are common in diabetic patients. The aim of 
      this study is to identify predictive factors for lower limb amputation (LLA) in 
      order to better identify this at-risk population. METHODS: This was a 
      cross-sectional study involving 134 patients who were hospitalised for the 
      management of T2DM complicated by diabetic foot, in the department of 
      endocrinology and diabetology. We included patients with T2DM whose diabetes was 
      diagnosed 10 years ago or more, and who had a diabetic foot problem. Statistical 
      differences between predictors of amputations were tested using: t-tests for 
      numerical variables and chi-square tests for categorical variables. Significant 
      variables were analysed by logistic regression to determine significant 
      predictors. RESULTS: The mean duration of diabetes was 17+/-7 years. We found that 
      70% of patients with LLA were older than 50 years (p<10-3). The prevalence of LLA 
      was higher (p=0.015) in patients with diabetes for more than 20 years. We noted 
      that 58% of patients who underwent LLA were hypertensive (p<10-3). The majority 
      of patients with LLA (58%) had abnormal micro-albuminuria (p<10-3). We found that 
      70% (n=12) of patients with LLA had low-density protein cholesterol levels above 
      the target value (p<10(-3)). Diabetic foot grade >/=4 (4 or 5) according to 
      Wagner's classification, was present in 24% of amputee patients. Based on a 95% 
      confidence interval level, the independent significant predictive factors for LLA 
      in our patients were: T2DM for more than 20 years, hypertension and diabetic foot 
      grade >/=4. CONCLUSIONS: After multivariate analysis, the significant independent 
      predictive factors associated with LLA were: T2DM for more than 20 years, 
      hypertension, and diabetic foot grade >/=4. Early management of diabetic foot 
      problems is therefore recommended to avoid amputations.
CI  - Copyright (c) 2023, Nouira et al.
FAU - Nouira, Sawsen
AU  - Nouira S
AD  - Department of Endocrinology, University Hospital of Farhat Hached, Sousse, TUN.
FAU - Ach, Taieb
AU  - Ach T
AD  - Department of Endocrinology, University Hospital of Farhat Hached, Sousse, TUN.
FAU - Bellazreg, Foued
AU  - Bellazreg F
AD  - Department of Infectious Diseases, University Hospital of Farhat Hached, Sousse, 
      TUN.
FAU - Ben Abdelkrim, Asma
AU  - Ben Abdelkrim A
AD  - Department of Endocrinology, University Hospital of Farhat Hached, Sousse, TUN.
LA  - eng
PT  - Journal Article
DEP - 20230605
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10321308
OTO - NOTNLM
OT  - diabetic foot ulcer management
OT  - lower limb amputation
OT  - peripheral arterial diseases
OT  - peripheral sensory neuropathy
OT  - type 2 diabetes mellitus
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/07/07 06:42
MHDA- 2023/07/07 06:43
PMCR- 2023/06/05
CRDT- 2023/07/07 04:02
PHST- 2023/06/05 00:00 [accepted]
PHST- 2023/07/07 06:43 [medline]
PHST- 2023/07/07 06:42 [pubmed]
PHST- 2023/07/07 04:02 [entrez]
PHST- 2023/06/05 00:00 [pmc-release]
AID - 10.7759/cureus.39987 [doi]
PST - epublish
SO  - Cureus. 2023 Jun 5;15(6):e39987. doi: 10.7759/cureus.39987. eCollection 2023 Jun.