The Association of HbA_1c Variability with 12 Week and 12 Month Outcomes on Diabetes Related Foot Ulcer Healing.

IF 3.8 3区医学 Q2 Medicine Diabetes Therapy Pub Date : 2024-10-01 Epub Date: 2024-08-17 DOI:10.1007/s13300-024-01640-4

Georgia Thomason, Catherine Gooday, Ian Nunney, Ketan Dhatariya

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Abstract

Introduction: This study aimed to determine the relationship between HbA_1c variability and foot ulcer healing at 12 weeks and 12 months.

Methods: Using National Diabetic Foot Care Audit (NDFA) and hospital records, demographics, baseline ulcer characteristics and healing outcomes for subjects presenting with a foot ulcer between 2017-2022 were collected at 12 weeks and 12 months. Subjects had diabetes duration > 3 years and ≥ 3 HbA_1c recordings in the 5 years prior to presentation.

Results: At 12 weeks, factors associated with an active ulcer were presence on hind foot (adjusted odds ratios) (2.1 [95% CI 1.3-3.7]), ischaemia (2.1 [95% CI:1.4-3.2]), area > 1 cm² (2.7 [95% CI:1.7-4.2]) and diabetes duration > 24 years vs 3-10 (AOR 2.0 [95% CI 1.2-3.5]). After adjustment, HbA_1c variability 6-10 mmol/mol and > 14.5 mmol/mol had AOR of 1.76 (95% CI 1.1-2.8; p = 0.0192) and 1.5 (95% CI 0.9-2.6; p = 0.1148) of an active ulcer at 12 weeks vs variability < 6 mmol/mol. At 12 months, ischaemia (AOR 2.4 [95% CI 1.5-3.8]) and diabetes duration > 24 years vs 3-10 years (AOR 3.3 [95% CI 1.7-6.4] were significant factors. HbA_1c variability was not significant at 12 months.

Conclusion: In keeping with the national NDFA data, in our cohort ulcer characteristics, but not HbA_1c variability, were the key factors associated with ulcer healing at 12 weeks and 12 months.

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HbA1c 变异性与糖尿病足溃疡愈合 12 周和 12 个月结果的关系。

简介本研究旨在确定12周和12个月时HbA1c变异性与足部溃疡愈合之间的关系：利用国家糖尿病足护理审计（NDFA）和医院记录，收集2017-2022年间出现足部溃疡的受试者在12周和12个月时的人口统计学、基线溃疡特征和愈合结果。受试者糖尿病病程>3年，发病前5年内HbA1c记录≥3次：12周时，与活动性溃疡相关的因素有：后足（调整后的几率比）（2.1 [95% CI 1.3-3.7]）、缺血（2.1 [95% CI:1.4-3.2]）、面积大于1平方厘米（2.7 [95% CI:1.7-4.2]）和糖尿病病程大于24年与3-10年（AOR 2.0 [95% CI 1.2-3.5]）。经调整后，HbA1c 变异性 6-10 mmol/mol 和 > 14.5 mmol/mol 在 12 周时出现活动性溃疡的 AOR 为 1.76 (95% CI 1.1-2.8; p = 0.0192) 和 1.5 (95% CI 0.9-2.6; p = 0.1148) vs 变异性 24 年 vs 3-10 年（AOR 3.3 [95% CI 1.7-6.4] 是显著因素。12个月时的 HbA1c 变异性不显著：结论：与全国 NDFA 数据一致，在我们的队列中，溃疡特征而非 HbA1c 变异是 12 周和 12 个月时溃疡愈合的关键因素。

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来源期刊

Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.90

自引率

7.90%

发文量

130

审稿时长

6 weeks

期刊介绍： Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.