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      Clinical Characteristics, Treatment, and Prognosis of Diabetic Foot Disease in Macao and Beijing: A Retrospective Study

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          Abstract

          Introduction

          There has been no epidemiological study of diabetes mellitus (DM) in Macao. Also, multidisciplinary treatment is yet to be popularized and complications of DM cannot be managed promptly in this region. Therefore, this study was performed to compare the clinical characteristics, treatment, and prognosis of diabetic foot disease between patients in Macao and Beijing.

          Methods

          A total of 243 patients with diabetic foot disease were enrolled: 124 from a tertiary hospital in Beijing and 119 from a tertiary hospital in Macao. The clinical profiles were collected and analyzed.

          Results

          The surgical treatment rate in the Beijing group (96.0%) was significantly higher than that in the Macao group (21.0%) ( P < 0.05). The overall mortality rate was 14.8%, and cardiac failure was the most common cause (72.2%). Monthly household income and smoking were independent factors affecting the age of onset. Age of diabetes onset was a risk factor for the occurrence of diabetic foot disease; age, duration of diabetic foot disease, and length of smoking history were independent factors affecting the severity of diabetic foot disease. Renal dysfunction and activated partial thromboplastin time were independent factors affecting the survival time of patients with diabetic foot disease.

          Conclusions

          Smoking may be a risk factor for the occurrence and development of diabetic foot; it can significantly reduce the onset age and aggravate the severity of this disease. The onset age of diabetic foot was lower in high-income patients, and prevention should be encouraged in this population. Elderly age may be associated with a rapidly developing and severe diabetic foot. The clinical course was also associated with the severity of diabetic foot. Renal and coagulation function should be closely monitored during the treatment of diabetic foot.

          Electronic supplementary material

          The online version of this article (10.1007/s13300-020-00805-1) contains supplementary material, which is available to authorized users.

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          Most cited references9

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          The management of diabetic foot: A clinical practice guideline by the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine.

          Diabetes mellitus continues to grow in global prevalence and to consume an increasing amount of health care resources. One of the key areas of morbidity associated with diabetes is the diabetic foot. To improve the care of patients with diabetic foot and to provide an evidence-based multidisciplinary management approach, the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine developed this clinical practice guideline.
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            Prevention and treatment of diabetic foot ulcers.

            The rising prevalence of diabetes estimated at 3.6 million people in the UK represents a major public health and socioeconomic burden to our National Health Service. Diabetes and its associated complications are of a growing concern. Diabetes-related foot complications have been identified as the single most common cause of morbidity among diabetic patients. The complicating factor of underlying peripheral vascular disease renders the majority of diabetic foot ulcers asymptomatic until latter evidence of non-healing ulcers become evident. Therefore, preventative strategies including annual diabetic foot screening and diabetic foot care interventions facilitated through a multidisciplinary team have been implemented to enable early identification of diabetic patients at high risk of diabetic foot complications. The National Diabetes Foot Care Audit reported significant variability and deficiencies of care throughout England and Wales, with emphasis on change in the structure of healthcare provision and commissioning, improvement of patient education and availability of healthcare access, and emphasis on preventative strategies to reduce morbidities and mortality of this debilitating disease. This review article aims to summarise major risk factors contributing to the development of diabetic foot ulcers. It also considers the key evidence-based strategies towards preventing diabetic foot ulcer. We discuss tools used in risk stratification and classifications of foot ulcer.
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              Is Open Access

              Diabetic foot infections: what have we learned in the last 30 years?

              Infection is a common epiphenomenon of advanced diabetic foot disease and the most common reason for diabetes-related hospitalizations and lower extremity amputations. Major advances have been made in the past three decades in our understanding and management of diabetic foot infections (DFIs). The optimal treatment of DFIs clearly involves multidisciplinary input.
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                Author and article information

                Contributors
                huilee@vip.sina.com
                Journal
                Diabetes Ther
                Diabetes Ther
                Diabetes Therapy
                Springer Healthcare (Cheshire )
                1869-6953
                1869-6961
                5 April 2020
                5 April 2020
                May 2020
                : 11
                : 5
                : 1119-1133
                Affiliations
                [1 ]GRID grid.24696.3f, ISNI 0000 0004 0369 153X, Department of Vascular Surgery, Beijing Chaoyang Hospital, , Capital Medical University, ; Beijing, 100020 China
                [2 ]GRID grid.460996.4, ISNI 0000 0004 1798 3082, Department of General Surgery, , Hospital Conde S. Januário, ; Macau, 999078 China
                [3 ]GRID grid.460996.4, ISNI 0000 0004 1798 3082, Department of Radiology, , Hospital Conde S. Januário, ; Macau, 999078 China
                [4 ]GRID grid.24696.3f, ISNI 0000 0004 0369 153X, Department of Thoracic Surgery, Beijing Chaoyang Hospital, , Capital Medical University, ; Beijing, 100020 China
                Article
                805
                10.1007/s13300-020-00805-1
                7192977
                32249374
                5046d1e1-f81c-494a-882b-f2881d18408a
                © The Author(s) 2020
                History
                : 3 December 2019
                Funding
                Funded by: science and technology development fund of the Macao special administrative region
                Award ID: 110/2015/A
                Categories
                Original Research
                Custom metadata
                © The Author(s) 2020

                Endocrinology & Diabetes
                beijing,diabetic foot,macao,risk factor
                Endocrinology & Diabetes
                beijing, diabetic foot, macao, risk factor

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