Complication rate among people with diabetes at low risk of foot ulceration in Fife, UK: an analysis of routinely collected data. Issue 12 (5th July 2020)

• Record Type: Journal Article
• Authors: Heggie, R.; Chappell, F.; Crawford, F.; Martin, A.; Gupta, S.; Hawkins, N.; Horne, M.; Leese, G. P.; Lewsey, J.
• Is Part Of: Diabetic medicine. Volume 37:Issue 12(2020)
• Page Start: 2116
• Page End: 2123
• Publication Date: 2020-07-05
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.14339
• Languages: English
• ISSNs: 0742-3071

Abstract

Abstract: Aims: To estimate the rate at which people with diabetes and a low risk of foot ulceration change diabetic foot ulceration risk status over time, and to estimate the rate of ulceration, amputation and death among this population. Methods: We conducted an observational study of 10 421 people with diabetes attending foot screening in an outpatient setting in NHS Fife, UK, using routinely collected data from a national diabetes register, NHS SCI Diabetes. We estimated the proportion of people who changed risk status and the cumulative incidence of ulceration, amputation and death, respectively, among people with diabetes at low risk of diabetic foot ulceration at 2‐year follow‐up. Results: At 2‐year follow‐up, 5.1% (95% CI 4.7, 5.6) of people with diabetes classified as low risk at their first visit had progressed to moderate risk. The cumulative incidence of ulceration, amputation and death was 0.4% (95% CI 0.3, 0.6), 0.1% (95% CI 0.1, 0.2) and 3.4% (95% CI 3.1, 3.8), respectively. Conclusions: At 2‐year follow‐up, 5% of people at low risk of diabetic foot ulceration changed clinical risk status and <1% of people experienced foot ulceration or amputation. These findings provide information which will help to inform the current debate regarding optimal foot screening intervals. What's new?: People with diabetes are at increased risk of foot ulceration. However, there is no evidence regarding the rate at which people at low risk of diabetic foot ulceration change risk status over time. This study found that people with diabetes who are at a low risk of foot ulceration do not readily change ulceration risk status over time (5% at 2 years). The cumulative incidence of ulceration and amputation, respectively, at 2 years was <1%. This has implications for current guidelines on the frequency of foot screening in the UK.