Foot Ulcers Linked to Greater Hospitalization, Death Risk

Text Size:
Foot Ulcers Linked to Greater Hospitalization, Death Risk

People with diabetes who develop foot ulcers are at much greater risk for hospitalization and death from chronic health conditions, according to a new study published in the journal Diabetes Research and Clinical Practice.

Foot ulcers — open sores on the foot that don’t easily heal — are a potential complication of diabetes, and are more likely to develop when someone has a history of poor blood glucose control. They are often the result of peripheral artery disease (PAD), which can reduce the blood supply to the feet, and peripheral neuropathy, which can reduce sensation in the feet and make it more difficult for people to know when they develop an injury or are irritating an existing wound. In the most serious cases, foot ulcers can become infected and lead to tissue death and amputation of the toes, feet, or legs. But recent research suggests that most people with diabetic foot ulcers won’t require an amputation, and are more likely to die from other health conditions before their ulcers get bad enough that amputation would be considered. On a more positive note, the last few years have seen advances in care for foot ulcers, and a new topical drug treatment was shown to be effective at helping ulcers heal in a study published last year.

To get cutting-edge diabetes news, strategies for blood glucose management, nutrition tips, healthy recipes, and more delivered straight to your inbox, sign up for our free newsletters!

For the latest study, researchers looked at how likely people with diabetic foot ulcers were to be hospitalized, or to die, during an active episode of ulcers. Using data from the U.S. Medicare program between 2013 and 2019, they identified active episodes of ulcers by comparing Medicare claims related to ulcer treatment with known facts about ulcer healing and care — such as the healing rate after 12 weeks, and the rate of developing an ulcer again after healing. By developing this model for active ulcers, they were able to compare the risk for hospitalization and death during these active periods with other periods during which people didn’t have active ulcers. The study included data from 78,716 Medicare beneficiaries with an average age of 70.9, all of whom had at least one episode of a diabetic foot ulcer. The average number of foot ulcer episodes per person was 2.6 during the study period, as noted in a Healio article on the study.

Active foot ulcers linked to increased hospitalization, death risk

The researchers found that compared with periods after foot ulcers had healed, people with foot ulcers were 2.8 times as likely to be hospitalized and 1.5 times as likely to die while they had an active ulcer. Overall, the healing rate for ulcers after 12 weeks was found to be 29.2%. After foot ulcers healed, within six months there was a recurrence of ulcers 26.7% of the time. The average duration between foot ulcers being identified and healing was 12.1 weeks, and the median duration between foot ulcer healing and recurring was about three years.

These results, the researchers concluded, support the need to help prevent foot ulcers in the first place — not just because of the direct impact of foot ulcers on health, but because of the greater risk for hospitalization and death from all causes during periods of active ulcers. Proactive steps to help prevent foot ulcers may include optimizing blood glucose control, getting enough physical activity, and taking care of your feet by protecting them from injury and having them examined at a regular interval.

Want to learn more about foot ulcers? Read “Diabetic Foot Ulcers: What They Are and How You Can Avoid Them?”

Quinn Phillips

Quinn Phillips

Quinn Phillips on social media

A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

Get Diabetes-Friendly Recipes In Your Inbox

Sign up for Free

Stay Up To Date On News & Advice For Diabetes

Sign up for Free

Get On Track With Daily Lifestyle Tips

Sign up for Free

Save Your Favorites

Save This Article