Work

Age‐related variations in clinical characteristics of patients with diabetic foot ulcers

Year: 2025

Type: article

Abstract: OBJECTIVE: Diabetic foot ulcers (DFUs) have increasingly affected younger populations. This study aimed to analyze the clinical characteristics of DFUs in different age groups of diabetic patients with foot ulcers. METHODS: This is a retrospective cohort study of diabetic patients with foot ulcers admitted to West China Hospital, Sichuan University. They were divided into the young (<45 years), the middle-aged (45-64 years), and the elderly groups (≥65 years). The patients were followed up for a median of 44.5 months, either at the outpatient department or by phone. RESULTS: This study enrolled 1,209 patients with DFUs, stratified into three groups according to age: young (n = 65), middle-aged (n = 509), and elderly (n = 635). All patients had a long history of diabetes with an average duration of 11.5 years. The DFU patients of all ages have poor glycemic control. About one-third of the patients have recurrent foot ulcers. The prevalence of comorbidities such as hypertension, coronary artery disease, chronic kidney disease, and peripheral artery disease increased significantly with age (P < 0.001). Neuropathic foot ulcers were more common in the young patients (48.3%), whereas neuro-ischemic ulcers were more prevalent in the middle-aged (42.1%) and elderly patients (56.9%). Compared with the young (27.7%) and middle-aged patients (26.9%), the ulcer healing rates during hospitalization were significantly lower in the elderly patients (18.9%, P = 0.004). During a median 44.5 (IQR 18.7-74.5)-month follow-up period, 375 (36.2%) deaths occurred, and all-cause mortality increased significantly with age (P < 0.001). CONCLUSION: Clinical characteristics of DFUs are profoundly age-dependent: younger patients exhibited poorer glycemic control, neuropathic ulcers, and mechanical injuries, while the older patients developed more vascular complications and neuro-ischemic ulcers. Therefore, different prevention and treatment measures should be taken for DFUs based on their clinical characteristics in different age groups.

Source: Journal of Diabetes Investigation

DOI: 10.1111/jdi.70181