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Poor prognosis for more than half with diabetic foot ulcers

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Less than half of patients with an infected diabetic foot ulcer will see it heal within a year, according to UK researchers, who said close monitoring and rapid treatment was key.

They found more than half of the patients in their study did not see their ulcer heal over 12 months, and one in seven had to have part or all of their foot amputated.

“The key point is that people need to be seen quickly if an ulcer begins to form”

Andrea Nelson

The study authors, led by Professor Andrea Nelson from the University of Leeds, said their results underlined the need for people at risk of foot ulcers to be closely monitored.

The researchers tracked 299 people who had attended a diabetic clinic with an infected foot ulcer and followed them up a year later.

By then, 17.4% had part or all of their foot amputated. Among the others, only 45.5% had seen their ulcer heal and it had recurred in 9.6%. Meanwhile, 15.1% of participants had died.

The researchers noted that study participants with a single ulcer on their index foot had a higher incidence of healing than those with multiple ulcers.

“Clinical outcomes at 12 months for people with an infected diabetic foot ulcer are generally poor,” stated the authors in the journal Diabetic Medicine.

“Our data confirm the adverse prognostic effect of limb ischaemia, longer ulcer duration and the presence of multiple,” they said.

Professor Nelson added: “Foot ulcers are a very nasty condition. They’re painful and are debilitating. People with foot ulcers have limited mobility, and that brings with it a whole set of other risk factors – obesity and heart disease, for example.

“The key point is that people need to be seen quickly if an ulcer begins to form – that gives health workers the greatest chance of trying to treat the condition,” she said.

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