Double the mortality risk for people with type 2 diabetes and a foot complication than those without type 2 diabetes

New research has found that people with type 2 diabetes (T2D) with a foot complication have a mortality risk double that of those without T2D.

The study set out to quantify the impact of foot complications on mortality outcomes in people with T2D, and how routinely measured factors might modulate that risk.

Researchers, led by Mike Stedman from RES Consortium, and Adrian H Heald from the Faculty of Health and Medical Sciences at the University of Surrey, examined data from almost 12,000 people with T2D, with 5,583 new diagnoses and 3,921 deaths during 2010-2020.

They found that: “Patients with T2D but without a foot complication have a standardized mortality ratio (SMR_IMD) that is only slightly higher than that of the general population. Those diagnosed with a foot complication have a mortality risk that is double that of those without T2D.”

The research team reported: “The number of expected deaths was 2,135; after IMD (index of multiple deprivation) adjustment, there were 2,595 expected deaths. Therefore, excess deaths numbered 1326 (standardized mortality ratio 1.51).

“No foot complications were evident in n = 9,857. This group had an SMR_IMD of 1.13 and 2.74 life years lost per death (LYLD). In total, 2,979 patients had any foot complication recorded. In this group, the SMD_IMR was 2.29; of these, 2,555 (75%) had only one foot complication.

“Patients with a foot complication showed little difference in percentage HbA1c more than 58 mmol/mol. In multivariate analysis, for those with a foot complication and an albumin-to-creatinine ratio of more than 3 mg/mmol, the odds ratio (OR) for death was 1.93, and for an estimated glomerular filtration rate of less than 60 mL/min/1.73m2 , the OR for death was 1.92.”

Data was taken from the Salford Integrated Care Record, with annual expected deaths taken from Office of National Statistics mortality data.

Read the study in Diabetes, Obesity and Metabolism.

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