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Associations between diabetes-related foot disease, diabetes, and age-related complications in older patients

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Key summary points

AbstractSection Aim

To evaluate the association between diabetes-related foot disease and diabetes-related complications in older patients with diabetes mellitus.

AbstractSection Finding

We found that hypertension, diabetes-related peripheral neuropathy, and grip strength were significantly associated with diabetes-related foot disease in older patients with diabetes mellitus. Additionally, the combination of diabetes-related peripheral neuropathy and hypertension further increased the risk of diabetes-related foot disease in comparison with either of the two independently.

AbstractSection Messages

Patients presenting with a history of the aforementioned complications should have their feet examined at an early stage and engage in preventative measures against severe diabetes-related foot disease.

Abstract

Purpose

To examine the relationship of diabetes-related foot disease (DFD) with diabetes and age-related complications in older patients with diabetes mellitus (DM).

Methods

We examined 562 outpatients with diabetes, aged ≥ 65 years, for DFD. The variables collected in this study were demographics, DM-related complications, treatment method, and age-related complications. Differences in the complications were compared between patients with and without DFD. Logistic regression analysis was used to determine the associations of DFD with DM and age-related complications.

Results

A total of 246 patients (43.8%) had DFD. Logistic regression analysis identified low grip strength [Odds ratio (OR): 1.83, 95% confidence interval (CI) 1.21–2.76), hypertension (OR: 1.81, 95% CI 1.09–3.00), and diabetes-related peripheral neuropathy (DPN) (OR: 1.92, 95% CI 1.24–2.98) to be significantly associated with DFD. Patients with DPN and hypertension had a higher risk of DFD than patients with DPN or hypertension alone. Individuals with DPN and low grip strength (OR: 1.74, 95% CI 1.09–2.81) were at a lower risk than those with low grip strength alone.

Conclusion

Hypertension, DPN, and low grip strength were significantly associated with DFD in older patients with DM, with the risk of DFD being higher in patients with both DPN and hypertension. When considering DFD in older patients with DM, low grip strength should be considered equally important as a DM-related complication.

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Availability of data and materials

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

SPSS version 22 (IBM Corp., Armonk, NY) was used for statistical analysis.

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Acknowledgments

We would like to express our deep appreciation to the patients who visited the Diabetes Outpatient Department and participated in this study. Partial financial support was received from the Ministry of Health, Labor, and Welfare under the research grant for Longevity Sciences (30-25).

Funding

This work was supported, in part, by the Research Grant for Longevity Sciences (30–25) from the Ministry of Health, Labor and Welfare. The funding source had no role in the analysis, writing, or submission of this report.

Author information

Authors and Affiliations

  1. Department of Nursing, National Center for Geriatrics and Gerontology, Obu-shi, Aichi-ken, Japan

    Sayuri Sable-Morita

  2. Department of Nursing, School of Human Health Sciences, Nagoya University Graduate School of Medicine, Nagoya-shi, Aichi-ken, Japan

    Mika Okura

  3. Department of Endocrinology and Metabolism, Takeda Hospital, Kyouto-shi, Aichi-ken, Japan

    Takahisa Tanikawa

  4. Department of Endocrinology and Metabolism, National Center for Geriatrics and Gerontology, Obu-shi, Aichi-ken, Japan

    Syuji Kawashima

  5. Clinical Laboratory, National Center for Geriatrics and Gerontology, Obu-shi, Aichi-ken, Japan

    Haruhiko Tokuda

  6. National Center for Geriatrics and Gerontology, Obu-shi, Aichi-ken, Japan

    Hidenori Arai

Authors
  1. Sayuri Sable-Morita
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  2. Mika Okura
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  3. Takahisa Tanikawa
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  4. Syuji Kawashima
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  5. Haruhiko Tokuda
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  6. Hidenori Arai
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Contributions

Conceptualization: SS-M, MO; Methodology: SS-M, TT; Formal analysis and investigation: SS-M, TT, SK; Writing—original draft preparation: SS-M; Writing—review and editing: SS-M, TT, SK, HT; Funding acquisition: SS-M; Resources: SS-M; Supervision: HA. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sayuri Sable-Morita.

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Conflicts of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Conflict of Interest Committee of the National Center for Geriatrics and Gerontology (approved August 18, 2010, no. 467).

Consent to participate

Written informed consent was obtained from all individual participants included in the study.

Consent for publication

Patients signed informed consent regarding publishing their data and photographs. All data in the manuscript have been anonymized.

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Sable-Morita, S., Okura, M., Tanikawa, T. et al. Associations between diabetes-related foot disease, diabetes, and age-related complications in older patients. Eur Geriatr Med 12, 1003–1009 (2021). https://doi.org/10.1007/s41999-021-00491-7

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  • DOI: https://doi.org/10.1007/s41999-021-00491-7

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