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Introduction: We previously demonstrated in both a longitudinal study and in meta‐analysis (pooled relative‐risk RR, 2.45) that all‐cause mortality is significantly higher in people with diabetes foot ulceration (DFU) than with those without a foot ulcer. In this prospective study, we looked at the factors linked to mortality after presentation to podiatry with DFU. Methods: Ninety‐eight individuals recruited consecutively from the Salford Royal Hospital Multidisciplinary Foot Clinic in Spring 2016 were followed up for up to 48 months. Data concerning health outcomes were extracted from the electronic patient record (EPR). Results: Seventeen people (17) had type 1 diabetes mellitus, and 81 had type 2 diabetes mellitus. Thirty‐one were women. The mean age (range) was 63.6 (28–90) years with maximum diabetes duration 45 years. Mean HbA1c was 72 (95% CI: 67–77) mmol/mol; 97% had neuropathy (International Working Group on the Diabetic Foot (IWGDF) monofilament); 62% had vascular insufficiency (Doppler studies); 69% of ulcers were forefoot, and 23% of ulcers were hind foot in location. Forty of 98 (40%) patients died in follow‐up with 27% of death certificates including sepsis (not foot‐related) and 35% renal failure as cause of death. Multivariate regression analysis indicated a 6.3 (95% CI: 3.9–8.1) fold increased risk of death with hind foot ulcer, independent of age/BMI/gender/HbA1c/eGFR/total cholesterol level. Conclusion: This prospective study has indicated a very high long‐term mortality rate in individuals with DFU, greater for those with a hind foot ulcer and shown a close relation between risk of sepsis/renal failure and DFU mortality, highlighting again the importance of addressing all risk factors as soon as people present with a foot ulcer. [ABSTRACT FROM AUTHOR]

The article discusses a study which determined whether pronated or supinated foot structures contribute to neuromuscular deficits as measured by muscle reaction time to a simulated ankle-sprain mechanism. Involved in the study were thirty volunteers categorized into 3 groups based on navicular-drop-height measures. It was found that participants with pronated or supinated foot structures had slower peroneus longus reaction times.

Aims To determine whether geography and/or social deprivation influences the occurrence of foot ulcers or amputations in patients with diabetes. Methods A population-based cohort of people with diabetes ( n = 15 983) were identified between 2004 and 2006. Community and hospital data on diabetes care, podiatry care and onset of ulceration and amputation was linked using a unique patient identifier, which is used for all patient contacts with health-care professionals. Postcode was used to calculate social deprivation and distances to general practice and hospital care. Results Over 3 years' follow-up 670 patients with diabetes developed new foot ulcers (42 per 1000) and 99 proceeded to amputation (6 per 1000). The most deprived quintile had a 1.7-fold (95% CI 1.2-2.3) increased risk of developing a foot ulcer. Distance from general practitioner or hospital clinic and lack of attendance at community retinal screening did not predict foot ulceration or amputation. Previous ulcer ( OR 15.1, 95% CI 11.6-19.6), insulin use ( OR 2.7, 95% CI 2.1-3.5), absent foot pulses (5.9: 4.7-7.5) and impaired monofilament sensation ( OR 6.5, 95% CI 5.0-8.4) all predicted foot ulceration. Previous foot ulcer, absent pulses and impaired monofilaments also predicted amputation. Conclusion Social deprivation is an important factor, especially for the development of foot ulcers. Geographical aspects such as accessibility to the general practitioner or hospital clinic are not associated with foot ulceration or amputation in this large UK cohort study. [ABSTRACT FROM AUTHOR]