Mortality rates in people presenting with a new diabetes‑related foot ulcer: a cohort study with implications for management – published online 27/09/2024

Naomi Holman, Arthur C. Yelland, Bob Young, Jonathan Valabhji, William Jeffcoate, Fran Game

The management of diabetes-related foot ulcers through multi-disciplinary footcare teams tends to focus, and assess success, on ulcer healing. However, people with foot ulcers have high prevalence of cardiovascular and renal morbidity and are known to have reduced life expectancy. In this issue, Holman et al (https://doi.org/10.1007/s00125-024-06262-w) present findings from a nationwide analysis of 71,000 people presenting with diabetes-related foot ulcers in England and Wales, showing mortality rates of 8.2% and 14.4% at 26 weeks and 52 weeks, respectively. The authors highlight that whilst the severity of the ulcer at presentation to a multi-disciplinary footcare team was associated with higher mortality after 12 and 26 weeks, by 52 weeks these associations were reduced and cardiovascular and renal comorbidities were a stronger predictor of mortality. The authors conclude that in the context of high short-term mortality, teams managing people with diabetes-related foot ulcers should consider modifying the burdensome care and maximising quality of residual life, rather than an exclusive focus on healing.