TY - JOUR
T1 - Factors influencing diabetes-related foot ulcer healing in Australian adults
T2 - A prospective cohort study
AU - Tehan, Peta Ellen
AU - Burrows, Tracy
AU - Hawes, Morgan Brian
AU - Linton, Clare
AU - Norbury, Kate
AU - Peterson, Benjamin
AU - Walsh, Annie
AU - White, Diane
AU - Chuter, Vivienne Helaine
N1 - Funding Information:
We would like to extend our gratitude to every participant of this study, who without their assistance, this study would not have been possible. Open access publishing facilitated by Monash University, as part of the Wiley - Monash University agreement via the Council of Australian University Librarians.
Funding Information:
This project received funding from Wounds Australia, the national body for Australian wound clinicians and a registered charity. Wounds Australia did not have any input into the design, execution or interpretation of study findings.
Publisher Copyright:
© 2022 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.
PY - 2023/1
Y1 - 2023/1
N2 - Objective: Diabetes-related foot ulceration (DFU) is a common limb-threatening condition, which is complex and subsequently challenging to manage. The aim of this study was to determine the contribution of a range of clinical and social factors to the healing of diabetes-related foot ulceration in an Australian population. Research design and methods: This was a prospective cohort study of individuals with diabetes-related foot ulceration (DFU). Age, sex, medical history, medications, dietary supplementation (e.g. vitamin C intake) and smoking history were elicited at baseline. The index of relative socio-economic disadvantage (IRSD) was calculated. The Australian Eating Survey and International Physical Activity Questionnaire-short were administered. Wound history, size, grade, time to healing and infection were captured and monitored over 6 months. Logistic regression was performed to determine the relationship between healing and diet quality, toe systolic pressure, wound size at, IRSD, infection and previous amputation. Results: A total of 117 participants were included. The majority were male n = 96 (82%), socio-economically disadvantaged (mean IRSD 965, SD 60), and obese (BMI 36 kg/m2, SD 11) with a long history of diabetes (20 years, SD 11). Wounds were predominantly neuropathic (n = 85, 73%) and classified 1A (n = 63, 54%) on the University of Texas wound classification system with few infections (n = 23, 16%). Dietary supplementation was associated with 4.36 increased odds of healing (95% 1.28–14.84, p = 0.02), and greater levels of socio-economic advantage were also associated with increased odds of healing (OR 1.01, 95% CI 1.01–1.02, p = 0.03). Conclusions: In this cohort study of predominantly neuropathic, non-infected DFU, individuals who had greater levels of socio-economic advantage had significantly greater odds of DFU healing. Diet quality was poor in most participants, with individuals taking supplementation significantly more likely to heal.
AB - Objective: Diabetes-related foot ulceration (DFU) is a common limb-threatening condition, which is complex and subsequently challenging to manage. The aim of this study was to determine the contribution of a range of clinical and social factors to the healing of diabetes-related foot ulceration in an Australian population. Research design and methods: This was a prospective cohort study of individuals with diabetes-related foot ulceration (DFU). Age, sex, medical history, medications, dietary supplementation (e.g. vitamin C intake) and smoking history were elicited at baseline. The index of relative socio-economic disadvantage (IRSD) was calculated. The Australian Eating Survey and International Physical Activity Questionnaire-short were administered. Wound history, size, grade, time to healing and infection were captured and monitored over 6 months. Logistic regression was performed to determine the relationship between healing and diet quality, toe systolic pressure, wound size at, IRSD, infection and previous amputation. Results: A total of 117 participants were included. The majority were male n = 96 (82%), socio-economically disadvantaged (mean IRSD 965, SD 60), and obese (BMI 36 kg/m2, SD 11) with a long history of diabetes (20 years, SD 11). Wounds were predominantly neuropathic (n = 85, 73%) and classified 1A (n = 63, 54%) on the University of Texas wound classification system with few infections (n = 23, 16%). Dietary supplementation was associated with 4.36 increased odds of healing (95% 1.28–14.84, p = 0.02), and greater levels of socio-economic advantage were also associated with increased odds of healing (OR 1.01, 95% CI 1.01–1.02, p = 0.03). Conclusions: In this cohort study of predominantly neuropathic, non-infected DFU, individuals who had greater levels of socio-economic advantage had significantly greater odds of DFU healing. Diet quality was poor in most participants, with individuals taking supplementation significantly more likely to heal.
KW - cohort
KW - diabetes-related foot ulceration
KW - dietary intake
KW - socio-economic disadvantage
KW - supplementation
KW - ulcer
KW - wound
UR - http://www.scopus.com/inward/record.url?scp=85138045587&partnerID=8YFLogxK
U2 - 10.1111/dme.14951
DO - 10.1111/dme.14951
M3 - Article
C2 - 36054775
AN - SCOPUS:85138045587
SN - 0742-3071
VL - 40
JO - Diabetic Medicine
JF - Diabetic Medicine
IS - 1
M1 - e14951
ER -