Study Shows Increased Risk For Foot Infection-Related Hospitalizations In People With Diabetes

According to a recent publication in Diabetologia, there is an increased risk of infection-related hospitalization in patients with diabetes.¹ This includes foot infections, for which the risk of hospitalization was nearly six times greater in patients with diabetes than those without.  Remarkably, the risk for hospitalization in patients with diabetes for all infection types, including foot infection, respiratory infection, urinary tract infection, GI infection, sepsis, and post-operative infection was 67 percent higher than the non-diabetic group. In addition, the study authors noted a stronger association between diabetes and hospitalization related to infection in younger participants and Black patients.¹

For this prospective cohort analysis, Fang and colleagues analyzed data from the Atherosclerosis Risk in Communities (ARIC) study, an ongoing cohort study, in which they followed patients from four communities in the United States (Forsyth County, NC, Jackson, MS, Minneapolis, MN, and Washington County, MD) for an average of 24 years, from 1987-1989 to 2019. The study included over 12,000 patients. Of note, the group with diabetes also had an increased risk for infection-related mortality.¹

On the stairway to amputation,² infection is quite literally footsteps away. Therefore, it is critical that providers, patients and health systems focus on ways to prevent complications from diabetes, beginning with programs aimed at identifying and treating infections early. Part of this involves developing and implementing technology and telemedicine capabilities that can detect early warning signs for inflammation and tissue loss. However, until this becomes widely adopted in clinical practice, education, periodic check-ups and frequent patient-doctor communication may be the best tools we have.

Dr. Isaac is the Director of Research with Foot & Ankle Specialists of the Mid-Atlantic.

References

1. Fang M, Ishigami J, Echouffo-Tcheugui JB, et al. Diabetes and the risk of hospitalisation for infection: the Atherosclerosis Risk in Communities (ARIC) study. Diabetologia. Available at: https://doi.org/10.1007/s00125-021-05522-3 . Published August 4, 2021. Accessed August 16, 2021.

2. Rogers LC, Andros G, Caporusso J, Harkless LB, Mills Sr JL, Armstrong DG. Toe and flow: essential components and structure of the amputation prevention team. J Vasc Surg. 2010;52(3):23S-7S.