PULSE PRESSURE AND PREDICTION OF INCIDENT FOOT ULCERS IN TYPE 2 DIABETES
- Matteo Monami, MD, PhD (mmonami{at}libero.it) (edmannu{at}tin.it),
- Maria Vivarelli, RN,
- Carla Maria Desideri, MD,
- Claudia Colombi, MD,
- Niccolò Marchionni, MD and
- Edoardo Mannucci, MD
- Unit of Geriatric Medicine, Department of Cardiovascular Medicine, University of Florence and Azienda Ospedaliera Careggi, Florence, Italy
Abstract
Objectives— To assess the relevance of pulse pressure (PP) as a predictor of foot ulcers in type 2 diabetes.
Research design and methods— A cohort study was performed on a consecutive series of 1,945 type 2 diabetic outpatients without foot ulcer at baseline. Incident foot ulcers were identified through the Regional Hospital Discharge system, which contains ICD codes of current diagnoses.
Results— During a mean follow-up of 4.2±2.2 years, 86 ulcers were observed. After adjusting for confounders, the highest quartiles of PP had a 2.39[1.14-5.02]-fold risk of foot ulcers. When ischemic ulcers were considered separately, the highest PP quartile was associated with an increased age- and sex-adjusted risk (2.08[1.02-4.24]), whereas no increase of risk was observed for neuropathic ulcers.
Conclusion— Elevated PP represents an independent predictor of foot ulcers in diabetic patients; this parameter should be considered for the stratification of risk of ischemic or neuroischemic ulcers.
Footnotes
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- Received September 12, 2008.
- Accepted January 30, 2009.
- Copyright © American Diabetes Association
