Individuals with diabetic foot ulcers are at high risk of death in the short term. One third actually die within three years of developing this common diabetes complication.
This is the main message of the paper published in the European Journal of Internal Medicine coordinated by Matilde Monteiro-Soares, a researcher from CINTESIS – Center for Health Technology and Services Research and the Faculty of Medicine of the University of Porto (FMUP), in collaboration with researchers from i3S.
The study aimed to assess the mortality rate in persons with diabetic foot ulcers and to determine the main risk factors for death. About 300 patients followed at the Hospital Center of Vila Nova de Gaia / Espinho EPE were involved. On average, the participants were 67.6 years old and had suffered from the disease for 18.1 years. The overwhelming majority had type 2 diabetes.
According to Matilde Monteiro-Soares, about 30% of patients with diabetic foot ulcers died after three years. More than half of the deaths (52%) were due to infections, namely pneumonia (25%), followed by Cardiovascular diseases and malignant diseases with 22% and 8%, respectively.
“In diabetes, the risk of death from infections is quite high, and pneumonia and septicemia are the main threats”, says the researcher.
The results of the study also indicate that age and physical disability are associated with a higher risk of death, which is in line with other studies. This risk is independent of the type or severity of the ulcers.
Surprisingly, it was found that the participants who had suffered diabetic foot ulcers previously were at a lower risk of dying. One of the hypotheses raised is that these individuals with a previous history of complications have more medical care and are more “resilient”.
According to the specialist, diabetic foot ulcers are one of the complications of diabetes with the greatest impact on patients and health systems due to their high morbidity, mortality, and use of resources.
Previously, the CINTESIS research team had carried out another study according to which, after one year, 7% of individuals with type 2 diabetes developed diabetic foot ulcers. Most of the events occurred in people followed at a hospital, which were also those with the longest duration of diabetes and the most complications resulting from the disease.