Foot Ulceration Risk In Diabetic Patients A Cohort Study Of195Cases

Aim:observe whether skin autofluorescence (skin AF), the indicator for tissue advanced glycation endproducts (AGEs) level, could serve as risk factor for diabetic foot ulceration.Method:this study was based on a cross-section, observational study carried out in2009.195patients were enrolled for one year’s follow-up by telephone and outpatient clinic.According to results from the cross-sectional study patients were classified into3groups:low risk, high risk and ulcer. Ulcer group contains patients already had foot ulcer during cross sectional study, High risk group contains patients with toe vibration threshold≥25V, and/or ABI<0.9and without foot ulcer. Other patients were classified into low risk group. In telephone follow up blood glucose status, major diabetic complications, and foot ulcers were recorded.If patient agreed, they were invited to our outpatient’s clinic and received further investigation. Their VPT, ABI and other laboratory tests were recorded.Result:a total of195patients were followed up.7patients with incomplete original data were excluded.188patients received telephone follow-up,45of them were lost, including6cases of death.34patients received outpatient clinic follow up. Among them,6cases from low risk group were diagnosed to be high risk because their VPT raised up and over25v.1patients from high risk group developed a foot ulcer and was classified into ulcer group, whereas2patients with original foot ulcers were classified into high risk group because their foot ulcers were healed. During follow up, patients’ Hb1Ac, HDL and VPT levels were significantly differs from that of original study (p<0.05). skin AF was strongly correlated with patients age, duration of their diabetes, ABI,VPT and Cr level. No significant correlation were found between HbAlc、BUN and skin AF.Conclusion:in this study, skin AF, as it may reflect the tissue AGEs deposition, was proved to have significant correlation with risk factors for foot ulcers in diabetic patients. However, since the interval between cross-sectional study and follow up, no significant change of skin AF was observed. Large, multicenter, prospective studies were required for further investigate the potent of skin AF in assessing foot ulcer risk in diabetic patients.