Risk factors for foot infections in individuals with diabetes.


OBJECTIVE:To prospectively determine risk factors for foot infection in a cohort of people with diabetes. RESEARCH DESIGN AND METHODS:We evaluated then followed 1,666 consecutive diabetic patients enrolled in a managed care-based outpatient clinic in a 2-year longitudinal outcomes study. At enrollment, patients underwent a standardized general medical examination and detailed foot assessment and were educated about proper foot care. They were then rescreened at scheduled intervals and also seen promptly if they developed any foot problem. RESULTS:During the evaluation period, 151 (9.1%) patients developed 199 foot infections, all but one involving a wound or penetrating injury. Most patients had infections involving only the soft tissue, but 19.9% had bone culture-proven osteomyelitis. For those who developed a foot infection, compared with those who did not, the risk of hospitalization was 55.7 times greater (95% CI 30.3-102.2; P < 0.001) and the risk of amputation was 154.5 times greater (58.5-468.5; P < 0.001). Foot wounds preceded all but one infection. Significant (P < 0.05) independent risk factors for foot infection from a multivariate analysis included wounds that penetrated to bone (odds ratio 6.7), wounds with a duration >30 days (4.7), recurrent wounds (2.4), wounds with a traumatic etiology (2.4), and presence of peripheral vascular disease (1.9). CONCLUSIONS:Foot infections occur relatively frequently in individuals with diabetes, almost always follow trauma, and dramatically increase the risk of hospitalization and amputation. Efforts to prevent infections should be targeted at people with traumatic foot wounds, especially those that are chronic, deep, recurrent, or associated with peripheral vascular disease.


Diabetes Care


Diabetes care


Lavery LA,Armstrong DG,Wunderlich RP,Mohler MJ,Wendel CS,Lipsky BA




Has Abstract


2006-06-01 00:00:00














  • An analysis of dynamic forces transmitted through the foot in diabetic neuropathy.

    abstract:OBJECTIVE:Biomechanical studies in diabetic neuropathy have clearly demonstrated abnormal foot pressures, but information on other aspects of gait is limited. This study aimed to investigate and describe the forces transmitted through the foot during walking in diabetic subjects with varying degrees of peripheral neuro...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Shaw JE,van Schie CH,Carrington AL,Abbott CA,Boulton AJ

    更新日期:1998-11-01 00:00:00

  • Atherosclerotic vascular disease and its risk factors in non-insulin-dependent diabetic and nondiabetic subjects in Finland.

    abstract::A cross-sectional study on the prevalence of atherosclerotic vascular disease (ASVD) and its risk factors in non-insulin-dependent diabetic and nondiabetic subjects was carried out from 1982 to 1984 in East Finland (Kuopio) and West Finland (Turku), two areas known to differ markedly in prevalence of ASVD in the nondi...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Laakso M,Rönnemaa T,Pyörälä K,Kallio V,Puukka P,Penttilä I

    更新日期:1988-06-01 00:00:00

  • Ethnic and racial differences in diabetes care: The Insulin Resistance Atherosclerosis Study.

    abstract:OBJECTIVE:Diabetes and its complications disproportionately affect African Americans and Hispanics. Complications could be prevented with appropriate medical care. We compared five processes of care and three outcomes of care among African Americans, Hispanics, and non-Hispanic whites. RESEARCH DESIGN AND METHODS:We u...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究


    authors: Bonds DE,Zaccaro DJ,Karter AJ,Selby JV,Saad M,Goff DC Jr

    更新日期:2003-04-01 00:00:00

  • Biologic and immunologic in vivo and in vitro studies with biosynthetic human insulin.

    abstract::A preliminary study was performed to estimate the effect of biosynthetic human insulin (BHI) produced by the Eli Lilly Company in comparison with purified pork insulin (PPI) from the same manufacturer. Immunologic studies were done using an intradermal skin test with both insulins and in vitro studies binding with ser...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Federlin K,Laube H,Velcovsky HG

    更新日期:1981-03-01 00:00:00

  • Short form of the Chinese version Diabetes Quality of Life for Youth Scale: a psychometric testing in Taiwanese adolescents with type 1 diabetes.

    abstract:OBJECTIVE:To test the psychometric properties of the short form of the Chinese version Diabetes Quality of Life for Youth scale (C-DQOLY-SF). RESEARCH DESIGN AND METHODS:A 30-item C-DQOLY-SF was administered to 371 adolescents with type 1 diabetes. Exploratory and confirmatory factor analysis, correlation with HbA(1c)...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Wang RH,Lo FS,Chen BH,Hsu HY,Lee YJ

    更新日期:2011-09-01 00:00:00

  • Can new-onset diabetes after kidney transplant be prevented?

    abstract::Because the negative consequences of new-onset diabetes mellitus after transplantation (NODAT) diminish the significant gains of kidney transplantation, it is imperative to develop clinical interventions to reduce the incidence of NODAT. In this review, we discuss whether intensive lifestyle interventions that delay o...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审


    authors: Chakkera HA,Weil EJ,Pham PT,Pomeroy J,Knowler WC

    更新日期:2013-05-01 00:00:00

  • Factors associated with glycemic control. A cross-sectional nationwide study in 2,579 French children with type 1 diabetes. The French Pediatric Diabetes Group.

    abstract:OBJECTIVE:To determine on a large scale the multiple medical and nonmedical factors that influence glycemic control in the general population of children with diabetes, we performed a nationwide French cross-sectional study. RESEARCH DESIGN AND METHODS:We enrolled 2,579 patients aged 1-19 years with type 1 diabetes of...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究


    authors: Rosilio M,Cotton JB,Wieliczko MC,Gendrault B,Carel JC,Couvaras O,Ser N,Gillet P,Soskin S,Garandeau P,Stuckens C,Le Luyer B,Jos J,Bony-Trifunovic H,Bertrand AM,Leturcq F,Lafuma A,French Pediatric Diabetes Group,Bougnèr

    更新日期:1998-07-01 00:00:00

  • Circulating and dietary trans fatty acids and incident type 2 diabetes in older adults: the Cardiovascular Health Study.

    abstract:OBJECTIVE:To investigate the effects of trans fatty acids (TFAs) on type 2 diabetes mellitus (DM) by specific TFA subtype or method of assessment. RESEARCH DESIGN AND METHODS:In the Cardiovascular Health Study, plasma phospholipid trans (t)-16:1n9, t-18:1, and cis (c)/t-, t/c-, and t/t-18:2 were measured in blood draw...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Wang Q,Imamura F,Ma W,Wang M,Lemaitre RN,King IB,Song X,Biggs ML,Delaney JA,Mukamal KJ,Djousse L,Siscovick DS,Mozaffarian D

    更新日期:2015-06-01 00:00:00

  • Long-term Diet Quality and Risk of Type 2 Diabetes Among Urban Chinese Adults.

    abstract:OBJECTIVE:Little evidence exists regarding long-term diet quality and the risk of type 2 diabetes among Asian populations, who have undergone a nutrition transition and a diabetes epidemic. RESEARCH DESIGN AND METHODS:A total of 117,919 Chinese men and women, 40-74 years old, free of diabetes, cardiovascular disease, ...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Yu D,Zheng W,Cai H,Xiang YB,Li H,Gao YT,Shu XO

    更新日期:2018-04-01 00:00:00

  • Optimized autoantibody-based risk assessment in family members. Implications for future intervention trials.

    abstract:OBJECTIVE:To determine the best autoantibody-based testing strategy for recruiting relatives for future intervention trials and to establish the role of islet cell antibodies (ICAs) within this strategy. RESEARCH DESIGN AND METHODS:ICAs, insulin autoantibodies (IAAs), GAD antibodies, and IA-2 antibodies were determine...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Bingley PJ,Williams AJ,Gale EA

    更新日期:1999-11-01 00:00:00

  • Hypogonadotropic Hypogonadism in Men With Diabesity.

    abstract::One-third of men with obesity or type 2 diabetes have subnormal free testosterone concentrations. The lower free testosterone concentrations are observed in obese men at all ages, including adolescents at completion of puberty. The gonadotropin concentrations in these males are inappropriately normal; thus, these pati...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审


    authors: Dhindsa S,Ghanim H,Batra M,Dandona P

    更新日期:2018-07-01 00:00:00

  • Genetic Tools for Coronary Risk Assessment in Type 2 Diabetes: A Cohort Study From the ACCORD Clinical Trial.

    abstract:OBJECTIVE:We evaluated whether the increasing number of genetic loci for coronary artery disease (CAD) identified in the general population could be used to predict the risk of major CAD events (MCE) among participants with type 2 diabetes at high cardiovascular risk. RESEARCH DESIGN AND METHODS:A weighted genetic ris...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Morieri ML,Gao H,Pigeyre M,Shah HS,Sjaarda J,Mendonca C,Hastings T,Buranasupkajorn P,Motsinger-Reif AA,Rotroff DM,Sigal RJ,Marcovina SM,Kraft P,Buse JB,Wagner MJ,Gerstein HC,Mychaleckyj JC,Parè G,Doria A

    更新日期:2018-11-01 00:00:00

  • PEPCK gene as model of inhibitory effects of insulin on gene transcription.

    abstract::Regulation of gene transcription is a major action of insulin. Most of the greater than 20 examples of this effect involve the stimulation of transcription, but a few involve an inhibition. The inhibition of transcription of the phosphoenolpyruvate carboxykinase (PEPCK) gene has been studied in detail. Most of this ef...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审


    authors: O'Brien RM,Granner DK

    更新日期:1990-03-01 00:00:00

  • Clinical utility of nonenzymatically glycosylated blood proteins as an index of glucose control.

    abstract::This study compares the utility of nonenzymatically glycosylated serum proteins (lys-GSP) to glycosylated hemoglobins (HbA1a-c) as control indices of glucose homeostasis in patients with IDDM. The diagnostic value of lys-GSP was also examined in patients with non-insulin-dependent diabetes mellitus, in subjects with i...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Schleicher ED,Gerbitz KD,Dolhofer R,Reindl E,Wieland OH,Edelmann E,Haslbeck M,Kemmler W,Walter H,Mehnert H

    更新日期:1984-11-01 00:00:00

  • Head-to-head comparison of sirolimus- and paclitaxel-eluting stent in the same diabetic patient with multiple coronary artery lesions: a prospective, randomized, multicenter study.

    abstract:OBJECTIVE:It is still controversial whether sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) are equally effective in patients with diabetes. In these patients, multiple individual variables may be responsible for neointimal hyperplasia, thus making difficult the comparison of the two drug-eluting stent...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Tomai F,Reimers B,De Luca L,Galassi AR,Gaspardone A,Ghini AS,Ferrero V,Favero L,Gioffrè G,Prati F,Tamburino C,Ribichini F

    更新日期:2008-01-01 00:00:00

  • Determinants of elevated urinary albumin in the 4,937 type 2 diabetic subjects recruited for the DIABHYCAR Study in Western Europe and North Africa.

    abstract:OBJECTIVE:Whether ACE inhibition is useful for type 2 diabetic patients with micro- and macroalbuminuria remains unknown. The Non-Insulin-Dependent Diabetes, Hypertension, Microalbuminuria, Cardiovascular Events and Ramipril (DIABHYCAR) Study was set up to address this issue through a multicenter double-blind parallel ...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Marre M,Lièvre M,Vasmant D,Gallois Y,Hadjadj S,Reglier JC,Chatellier G,Mann J,Viberti GC,Passa P

    更新日期:2000-04-01 00:00:00

  • Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes.

    abstract::The consensus algorithm for the medical management of type 2 diabetes was published in August 2006 with the expectation that it would be updated, based on the availability of new interventions and new evidence to establish their clinical role. The authors continue to endorse the principles used to develop the algorith...

    journal_title:Diabetes care

    pub_type: 共识发展会议,杂志文章,实务指引


    authors: Nathan DM,Buse JB,Davidson MB,Ferrannini E,Holman RR,Sherwin R,Zinman B,American Diabetes Association.,European Association for Study of Diabetes.

    更新日期:2009-01-01 00:00:00

  • Relationship between hypoglycemic episodes and ventricular arrhythmias in patients with type 2 diabetes and cardiovascular diseases: silent hypoglycemias and silent arrhythmias.

    abstract:OBJECTIVE:In patients with type 2 diabetes and cardiovascular diseases (CVDs), intensive treatment with insulin and/or sulfonylurea (SU) may be associated with excessive increased risk of hypoglycemic episodes. To evaluate the risk of critical arrhythmias related to glycemic variability, we carried out an observational...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Stahn A,Pistrosch F,Ganz X,Teige M,Koehler C,Bornstein S,Hanefeld M

    更新日期:2014-02-01 00:00:00

  • Fetal hemoglobin in diabetic patients.

    abstract:OBJECTIVE:To determine the occurrence of elevated fetal hemoglobin (HbF) among the diabetic population and determine the clinical situation of importance. RESEARCH DESIGN AND METHODS:A cross-sectional study was conducted. HbA1c and HbF were measured with high-performance liquid chromatography in 1,104 consecutive diab...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章


    authors: Koskinen LK,Lahtela JT,Koivula TA

    更新日期:1994-08-01 00:00:00

  • Maternal and cord blood adiponectin multimeric forms in gestational diabetes mellitus: a prospective analysis.

    abstract:OBJECTIVE:To analyze the relationship between maternal adiponectin (mAdiponectin) and cord blood adiponectin (cbAdiponectin) multimeric forms (high molecular weight [HMW], medium molecular weight [MMW], and low molecular weight [LMW]) in a cohort of gestational diabetes mellitus (GDM) and normal glucose-tolerant (NGT) ...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Ballesteros M,Simón I,Vendrell J,Ceperuelo-Mallafré V,Miralles RM,Albaiges G,Tinahones F,Megia A

    更新日期:2011-11-01 00:00:00

  • Serum lipids and the progression of nephropathy in type 1 diabetes.

    abstract:OBJECTIVE:Dyslipidemia contributes to the progression of microvascular disease in diabetes. However, different lipid variables may be important at different stages of nephropathy. This study examines the pattern of dyslipidemia associated with the progression of nephropathy in patients with type 1 diabetes. RESEARCH D...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究


    authors: Thomas MC,Rosengård-Bärlund M,Mills V,Rönnback M,Thomas S,Forsblom C,Cooper ME,Taskinen MR,Viberti G,Groop PH

    更新日期:2006-02-01 00:00:00

  • A highly successful and novel model for treatment of chronic painful diabetic peripheral neuropathy.

    abstract:OBJECTIVE:To investigate why, in spite of a vast variety of treatment agents, the alleviation of pain in patients with diabetic neuropathy is difficult. Previous studies have not used a treatment algorithm based on anatomic site and neuropathophysiological source of the neuropathic pain. RESEARCH DESIGN AND METHODS:A ...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章


    authors: Pfeifer MA,Ross DR,Schrage JP,Gelber DA,Schumer MP,Crain GM,Markwell SJ,Jung S

    更新日期:1993-08-01 00:00:00

  • Stroke in the diabetic patient.

    abstract::A higher prevalence of stroke is found in the patient with both diagnosed and undiagnosed diabetes and glucose intolerance. Because of local cerebral acidosis caused by ischemia and hyperglycemia, morbidity and mortality from a stroke are increased. Most studies show that individuals with admission serum glucose > 120...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审


    authors: Bell DS

    更新日期:1994-03-01 00:00:00

  • Total plasma antioxidant capacity predicts thrombosis-prone status in NIDDM patients.

    abstract:OBJECTIVE:To explore the hypothesis that a relationship exists between free radical activity and abnormalities in hemostasis in NIDDM. RESEARCH DESIGN AND METHODS:The use of the total radical-trapping antioxidant parameter (TRAP) has very recently been proposed to explore the antioxidant property of a plasma and their...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Ceriello A,Bortolotti N,Pirisi M,Crescentini A,Tonutti L,Motz E,Russo A,Giacomello R,Stel G,Taboga C

    更新日期:1997-10-01 00:00:00

  • Plasma glucose regulation and mortality in pima Indians.

    abstract:OBJECTIVE:To evaluate whether impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are associated with increased risk of mortality and prevalent ischemic heart disease (IHD) and to analyze if the increased risk of death is dependent on subsequent development of diabetes in Pima Indians. RESEARCH DESI...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Kim NH,Pavkov ME,Looker HC,Nelson RG,Bennett PH,Hanson RL,Curtis JM,Sievers ML,Knowler WC

    更新日期:2008-03-01 00:00:00

  • Ocular Anti-VEGF therapy for diabetic retinopathy: the role of VEGF in the pathogenesis of diabetic retinopathy.

    abstract::Diabetic retinopathy is the leading cause of visual impairment and preventable blindness, and represents a significant socioeconomic cost for health care systems worldwide. Therefore, new approaches beyond current standards of diabetes care are needed. Based on the crucial pathogenic role of vascular endothelial growt...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审


    authors: Simó R,Sundstrom JM,Antonetti DA

    更新日期:2014-04-01 00:00:00

  • Relationship Among Diabetes Distress, Decisional Conflict, Quality of Life, and Patient Perception of Chronic Illness Care in a Cohort of Patients With Type 2 Diabetes and Other Comorbidities.

    abstract:OBJECTIVE:The primary outcome is to evaluate the relationship between diabetes distress and decisional conflict regarding diabetes care in patients with diabetes and two or more comorbidities. Secondary outcomes include the relationships between diabetes distress and quality of life and patient perception of chronic il...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Bruno BA,Choi D,Thorpe KE,Yu CH

    更新日期:2019-07-01 00:00:00

  • Baseline markers of inflammation are associated with progression to macroalbuminuria in type 1 diabetic subjects.

    abstract:OBJECTIVE:The current study aimed to determine in the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications cohort whether or not abnormal levels of markers of inflammation and endothelial dysfunction measured in samples collected at DCCT baseline were able to predict ...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验


    authors: Lopes-Virella MF,Baker NL,Hunt KJ,Cleary PA,Klein R,Virella G,DCCT\/EDIC Research Group.

    更新日期:2013-08-01 00:00:00

  • Clinical evaluation of a personalized artificial pancreas.

    abstract:OBJECTIVE:An artificial pancreas (AP) that automatically regulates blood glucose would greatly improve the lives of individuals with diabetes. Such a device would prevent hypo- and hyperglycemia along with associated long- and short-term complications as well as ease some of the day-to-day burden of frequent blood gluc...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章


    authors: Dassau E,Zisser H,Harvey RA,Percival MW,Grosman B,Bevier W,Atlas E,Miller S,Nimri R,Jovanovic L,Doyle FJ 3rd

    更新日期:2013-04-01 00:00:00

  • Concordance for type 1 diabetes in identical twins is affected by insulin genotype.

    abstract:OBJECTIVE:Monozygotic twins are usually discordant (only one twin affected) for type 1 diabetes. Discordance for disease between such twins implies a role for nongenetically determined factors but could also be influenced by a decreased load of diabetes susceptibility genes. The aim of this study was to determine wheth...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Metcalfe KA,Hitman GA,Rowe RE,Hawa M,Huang X,Stewart T,Leslie RD

    更新日期:2001-05-01 00:00:00