Incidence of diabetic foot ulcer in Japanese patients with type 2 diabetes mellitus

The Fukuoka diabetes registry

Masanori Iwase, Hiroki Fujii, Udai Nakamura, Toshiaki Ohkuma, Hitoshi Ide, Tamaki Jodai-Kitamura, Akiko Sumi, Yuji Komorita, Masahito Yoshinari, Takanari Kitazono

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aims: Although diabetic foot ulcer (DFU) is a serious diabetic complication, there have been no large-scale epidemiological studies of DFU in Japan. We prospectively investigated the incidences of DFU and limb amputation, the risk for developing DFU, and mortality in Japanese patients with type 2 diabetes. Methods: We followed 4870 participants (mean age, 65 years) with type 2 diabetes attending an outpatient diabetes clinic for a median of 5.3 years (follow-up rate, 97.7%). The primary outcome was the development of DFU. Results: During the follow-up period, DFU occurred in 74 participants (incidence rate, 2.9/1000 person-years) and limb amputation in 12 (incidence rate, 0.47/1000 person-years). DFU recurrence was observed in 21.4% of participants with history of DFU. History of DFU, chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 m2), depressive symptoms, and poor glycemic control were significant risk factors for developing DFU. Survival was significantly lower in participants with DFU and/or history of DFU compared with those without (5-year survival rates: with DFU, 87.7%, without DFU, 95.3%; P <.0001). The hazard ratio for death was 1.80 (95% confidence interval, 1.13–2.73, P =.014) in those with DFU and/or history of DFU in a multi-adjusted model. The most common cause of death was cardiovascular disease among participants with DFU, whereas it was malignant neoplasm among those without. Conclusions: Incidences of DFU and limb amputation were 0.3% and 0.05% per year in this Japanese cohort, respectively. Mortality significantly increased approximately 2-fold in those with DFU and/or history of DFU compared with those without.

Original languageEnglish
Pages (from-to)183-189
Number of pages7
JournalDiabetes Research and Clinical Practice
Volume137
DOIs
Publication statusPublished - Mar 1 2018

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Diabetic Foot
Type 2 Diabetes Mellitus
Registries
Incidence
Amputation
Extremities

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Incidence of diabetic foot ulcer in Japanese patients with type 2 diabetes mellitus : The Fukuoka diabetes registry. / Iwase, Masanori; Fujii, Hiroki; Nakamura, Udai; Ohkuma, Toshiaki; Ide, Hitoshi; Jodai-Kitamura, Tamaki; Sumi, Akiko; Komorita, Yuji; Yoshinari, Masahito; Kitazono, Takanari.

In: Diabetes Research and Clinical Practice, Vol. 137, 01.03.2018, p. 183-189.

Research output: Contribution to journalArticle

Iwase, Masanori ; Fujii, Hiroki ; Nakamura, Udai ; Ohkuma, Toshiaki ; Ide, Hitoshi ; Jodai-Kitamura, Tamaki ; Sumi, Akiko ; Komorita, Yuji ; Yoshinari, Masahito ; Kitazono, Takanari. / Incidence of diabetic foot ulcer in Japanese patients with type 2 diabetes mellitus : The Fukuoka diabetes registry. In: Diabetes Research and Clinical Practice. 2018 ; Vol. 137. pp. 183-189.
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abstract = "Aims: Although diabetic foot ulcer (DFU) is a serious diabetic complication, there have been no large-scale epidemiological studies of DFU in Japan. We prospectively investigated the incidences of DFU and limb amputation, the risk for developing DFU, and mortality in Japanese patients with type 2 diabetes. Methods: We followed 4870 participants (mean age, 65 years) with type 2 diabetes attending an outpatient diabetes clinic for a median of 5.3 years (follow-up rate, 97.7{\%}). The primary outcome was the development of DFU. Results: During the follow-up period, DFU occurred in 74 participants (incidence rate, 2.9/1000 person-years) and limb amputation in 12 (incidence rate, 0.47/1000 person-years). DFU recurrence was observed in 21.4{\%} of participants with history of DFU. History of DFU, chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 m2), depressive symptoms, and poor glycemic control were significant risk factors for developing DFU. Survival was significantly lower in participants with DFU and/or history of DFU compared with those without (5-year survival rates: with DFU, 87.7{\%}, without DFU, 95.3{\%}; P <.0001). The hazard ratio for death was 1.80 (95{\%} confidence interval, 1.13–2.73, P =.014) in those with DFU and/or history of DFU in a multi-adjusted model. The most common cause of death was cardiovascular disease among participants with DFU, whereas it was malignant neoplasm among those without. Conclusions: Incidences of DFU and limb amputation were 0.3{\%} and 0.05{\%} per year in this Japanese cohort, respectively. Mortality significantly increased approximately 2-fold in those with DFU and/or history of DFU compared with those without.",
author = "Masanori Iwase and Hiroki Fujii and Udai Nakamura and Toshiaki Ohkuma and Hitoshi Ide and Tamaki Jodai-Kitamura and Akiko Sumi and Yuji Komorita and Masahito Yoshinari and Takanari Kitazono",
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T1 - Incidence of diabetic foot ulcer in Japanese patients with type 2 diabetes mellitus

T2 - The Fukuoka diabetes registry

AU - Iwase, Masanori

AU - Fujii, Hiroki

AU - Nakamura, Udai

AU - Ohkuma, Toshiaki

AU - Ide, Hitoshi

AU - Jodai-Kitamura, Tamaki

AU - Sumi, Akiko

AU - Komorita, Yuji

AU - Yoshinari, Masahito

AU - Kitazono, Takanari

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Aims: Although diabetic foot ulcer (DFU) is a serious diabetic complication, there have been no large-scale epidemiological studies of DFU in Japan. We prospectively investigated the incidences of DFU and limb amputation, the risk for developing DFU, and mortality in Japanese patients with type 2 diabetes. Methods: We followed 4870 participants (mean age, 65 years) with type 2 diabetes attending an outpatient diabetes clinic for a median of 5.3 years (follow-up rate, 97.7%). The primary outcome was the development of DFU. Results: During the follow-up period, DFU occurred in 74 participants (incidence rate, 2.9/1000 person-years) and limb amputation in 12 (incidence rate, 0.47/1000 person-years). DFU recurrence was observed in 21.4% of participants with history of DFU. History of DFU, chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 m2), depressive symptoms, and poor glycemic control were significant risk factors for developing DFU. Survival was significantly lower in participants with DFU and/or history of DFU compared with those without (5-year survival rates: with DFU, 87.7%, without DFU, 95.3%; P <.0001). The hazard ratio for death was 1.80 (95% confidence interval, 1.13–2.73, P =.014) in those with DFU and/or history of DFU in a multi-adjusted model. The most common cause of death was cardiovascular disease among participants with DFU, whereas it was malignant neoplasm among those without. Conclusions: Incidences of DFU and limb amputation were 0.3% and 0.05% per year in this Japanese cohort, respectively. Mortality significantly increased approximately 2-fold in those with DFU and/or history of DFU compared with those without.

AB - Aims: Although diabetic foot ulcer (DFU) is a serious diabetic complication, there have been no large-scale epidemiological studies of DFU in Japan. We prospectively investigated the incidences of DFU and limb amputation, the risk for developing DFU, and mortality in Japanese patients with type 2 diabetes. Methods: We followed 4870 participants (mean age, 65 years) with type 2 diabetes attending an outpatient diabetes clinic for a median of 5.3 years (follow-up rate, 97.7%). The primary outcome was the development of DFU. Results: During the follow-up period, DFU occurred in 74 participants (incidence rate, 2.9/1000 person-years) and limb amputation in 12 (incidence rate, 0.47/1000 person-years). DFU recurrence was observed in 21.4% of participants with history of DFU. History of DFU, chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 m2), depressive symptoms, and poor glycemic control were significant risk factors for developing DFU. Survival was significantly lower in participants with DFU and/or history of DFU compared with those without (5-year survival rates: with DFU, 87.7%, without DFU, 95.3%; P <.0001). The hazard ratio for death was 1.80 (95% confidence interval, 1.13–2.73, P =.014) in those with DFU and/or history of DFU in a multi-adjusted model. The most common cause of death was cardiovascular disease among participants with DFU, whereas it was malignant neoplasm among those without. Conclusions: Incidences of DFU and limb amputation were 0.3% and 0.05% per year in this Japanese cohort, respectively. Mortality significantly increased approximately 2-fold in those with DFU and/or history of DFU compared with those without.

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