The predictive role of inpatient hypoglycemia for amputations in patients with acute diabetic foot
10.3760/cma.j.issn.1000-6699.2019.12.015
- VernacularTitle: 急性糖尿病足患者住院期间低血糖事件可预测截肢的发生
- Author:
Jiali XIANG
1
;
Zhengyi TANG
Author Information
1. Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
- Publication Type:Journal Article
- Keywords:
Hyperglycemia;
Hypoglycemia;
Glucose variability;
Amputations;
Diabetic foot
- From:
Chinese Journal of Endocrinology and Metabolism
2019;35(12):1073-1078
- CountryChina
- Language:Chinese
-
Abstract:
In Nov 2019, " The Journal of Clinical Endocrinology & Metabolism" published an article " Association of inpatient glucose measurements with amputations in patients hospitalized with acute diabetic foot" [Peled S, Pollack R, Elishoov O, et al. J Clin Endocrinol Metab, 2019, 104(11): 5445-5452. DOI: 10.1210/jc.2019-00774], with the permission of the original journal, we translated it into Chinese. This article studied the relationship of glycemic indices during hospitalization with amputations in patients with acute diabetic foot. The retrospective cohort study included 418 patients admitted with acute diabetic foot in the diabetic foot unit during 2015-2017. Information on demographic characteristics, medical history, laboratory tests, and point-of-care glucose measurements were collected. The primary outcomes were any or major amputation during hospitalization. 45 496 glucose measurements were taken for 418 patients hospitalized with acute diabetic foot. Patients experiencing any hyperglycemia and any or severe hypoglycemia were more likely to undergo any or major amputations during hospitalization. High glycemic variability was associated with major amputations. Peripheral vascular disease, high Wagner score, and hypoglycemia were independent predictors of amputations. Older age, peripheral vascular disease, previous amputation, elevated white blood cell, high Wagner score, and hypoglycemia were independent predictors of major amputations. Hypoglycemia appeared to be an independent risk factor for any and major amputations. While it is unclear whether hypoglycemia directly contributes to adverse outcomes, efforts to minimize in-hospital hypoglycemic events are needed.
