| アブストラクト | AIMS: Diabetic foot ulceration (DFU) is a serious complication of diabetes. Frailty is common in individuals with type 2 diabetes and has been associated with a higher mortality risk. We investigated the risk of DFU and mortality in relation to frailty in individuals with type 2 diabetes. METHODS: We identified DFU and mortality events between 2000 and 2021 in the Clinical Practice Research Datalink GOLD primary care records linked to hospital and mortality data. Frailty was categorised using the electronic frailty index. We employed parametric multistate modelling to describe the transitions across the states 'Type 2 diabetes', 'DFU' and 'Mortality'. RESULTS: In 186,473 individuals with type 2 diabetes (median age, 62 years; 50.9 % women), 3,551 (1.9 %) developed DFU and 53,118 (28.5 %) died during a median follow-up of 8.8 years. Greater frailty was associated with higher rates of DFU and, especially, mortality. In women diagnosed at 60, the 10-year adjusted probability of DFU was 2.1 %, 1.9 %, 2.9 %, and 3.2 % for fit, mild, moderate, and severe frailty, respectively; corresponding estimates in men were 2.6 %, 2.7 %, 3.7 %, and 4.4 %. CONCLUSIONS: Information on age and frailty at type 2 diabetes diagnosis is necessary to enhance risk stratification and guide personalised diagnostic and therapeutic strategies for DFU. |
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| 投稿者 | Neal, Liam; Yates, Tom; Shabnam, Sharmin; McCarthy, Matthew; Dempsey, Paddy C; Davies, Melanie; Khunti, Kamlesh; Zaccardi, Francesco |
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| 組織名 | Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General;Hospital, University of Leicester, Leicester LE5 4PW, United Kingdom; Diabetes;Research Centre, Leicester General Hospital, University of Leicester, Leicester;LE5 4PW, United Kingdom. Electronic address: lgn2@leicester.ac.uk.;Diabetes Research Centre, Leicester General Hospital, University of Leicester,;Leicester LE5 4PW, United Kingdom; NIHR Leicester Biomedical Research Centre,;University Hospitals of Leicester NHS Trust and University of Leicester, United;Kingdom. Electronic address: ty20@leicester.ac.uk.;Hospital, University of Leicester, Leicester LE5 4PW, United Kingdom. Electronic;address: ss1279@leicester.ac.uk.;Leicester LE5 4PW, United Kingdom. Electronic address: mm636@leicester.ac.uk.;Leicester LE5 4PW, United Kingdom; Institute for Physical Activity and Nutrition;(IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong,;Victoria, Australia; Baker Heart & Diabetes Institute, Melbourne, Victoria,;Australia; MRC Epidemiology Unit, Institute of Metabolic Science, University of;Cambridge, Biomedical Campus, Cambridge, United Kingdom. Electronic address:;pcd5@leicester.ac.uk.;Kingdom. Electronic address: melanie.davies@uhl-tr.nhs.uk.;LE5 4PW, United Kingdom. Electronic address: kk22@leicester.ac.uk.;LE5 4PW, United Kingdom. Electronic address: fz43@leicester.ac.uk. |
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