Short-term glucose variability as a determinant of the healing rate of diabetic foot ulcer: A retrospective study.

Autor: Caruso P; Division of Endocrinology and Metabolic Diseases, University of Campania 'Luigi Vanvitelli', Naples, Italy., Scappaticcio L; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy., Gicchino M; Division of Endocrinology and Metabolic Diseases, University of Campania 'Luigi Vanvitelli', Naples, Italy., Castaldo F; Division of Endocrinology and Metabolic Diseases, University of Campania 'Luigi Vanvitelli', Naples, Italy., Barrasso M; Division of Endocrinology and Metabolic Diseases, University of Campania 'Luigi Vanvitelli', Naples, Italy., Carbone C; Division of Endocrinology and Metabolic Diseases, University of Campania 'Luigi Vanvitelli', Naples, Italy; PhD Program of Translational Medicine, Department of Experimental Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy., Caputo M; Division of Endocrinology and Metabolic Diseases, University of Campania 'Luigi Vanvitelli', Naples, Italy., Tomasuolo M; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy., Paglionico VA; Division of Endocrinology and Metabolic Diseases, University of Campania 'Luigi Vanvitelli', Naples, Italy; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy., Bellastella G; Division of Endocrinology and Metabolic Diseases, University of Campania 'Luigi Vanvitelli', Naples, Italy; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy., Maiorino MI; Division of Endocrinology and Metabolic Diseases, University of Campania 'Luigi Vanvitelli', Naples, Italy; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy. Electronic address: mariaida.maiorino@unicampania.it., Esposito K; Division of Endocrinology and Metabolic Diseases, University of Campania 'Luigi Vanvitelli', Naples, Italy; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy.
Jazyk: angličtina
Zdroj: Diabetes & metabolic syndrome [Diabetes Metab Syndr] 2024 Mar; Vol. 18 (3), pp. 102990. Date of Electronic Publication: 2024 Mar 16.
DOI: 10.1016/j.dsx.2024.102990
Abstrakt: Background: The aim of this study was to describe the clinical characteristics of people with diabetic foot ulcer (DFU) according to glucose variability (GV) and to investigate the relationship between GV and DFU outcome in a population with type 2 diabetes (T2D) and DFU.
Methods: This is a retrospective study of 300 individuals aged 64.3 years (181 males) treated for DFU in a tertiary-care center with a regular follow-up for 6 months. Laboratory measurements and clinical assessments were collected at baseline. According to the coefficient of variation (CV) cut-off (≥36%), people were divided into two groups (low and high GV).
Results: Compared with low GV group (n = 245), high GV group (n = 55) had significant longer duration of diabetes [low vs high GV, mean ± Standard Deviation (SD), 17.8 ± 11.8 vs 22.4 ± 10.8, P = 0.012], higher levels of glycated haemoglobin [median (IQR), 7.4 (6.6, 8.8) vs 8.2 (7.0, 9.6), P = 0.010] and urinary albumin excretion [25.2 (11.9, 77.0) vs 48.0 (23.2, 106.0), P = 0.031]. Moreover, 10 days self-monitoring of blood glucose-derived glycemic metrics were significantly different between groups. No differences among clinical features were found. The multiple logistic regression analysis identified CV and SD as negative predictors of healing.
Conclusions: In a population of people with T2D and DFU treated in a tertiary-care center, individuals with high GV had a 3-fold higher risk of healing failure, as compared with those with low GV. CV and SD were related to poor healing within 6 months follow-up.
Competing Interests: Declaration of competing interest M.I.M. received speaking and lecture fees from Novo Nordisk and Eli Lilly. K.E. received speaking and lecture fees from Novo Nordisk and Ely Lilly and has provided consultancy services to Roche. Other authors declare no conflict of interest.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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