{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:32:05Z","timestamp":1785774725796,"version":"3.56.0"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Although etiologic factors for diabetes\u2010related lower\u2010extremity amputation (LEA) have been extensively examined, the role of incident diabetic foot ulcer (DFU) has not been prospectively evaluated. We investigated the independent effect of incident DFU, among other limb\u2010 and person\u2010level factors, on LEA risk in a cohort of veterans with diabetes at one Department of Veterans Affairs general internal medicine clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We prospectively followed 1458 male U.S. veterans with 2893 lower limbs without DFU between 1990 and 2002 (mean follow\u2010up\u00a0=\u00a04.9\u00a0years). Potential risk factors were evaluated in proportional hazards and flexible parametric survival models and collected through interviews (demographic, lifestyle, and diabetes characteristics), physical examination (blood pressure, weight, Charcot deformity, visual acuity), and blood (albumin, HbA\n                      <jats:sub>1c<\/jats:sub>\n                      , and eGFR [estimated Glomerular filtration rate]) and neurovascular (10\u2010g monofilament, TcPO\n                      <jats:sub>2<\/jats:sub>\n                      , and ankle\u2010brachial index [ABI]) testing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During follow\u2010up, 227 (7.8%) DFUs occurred and 72 (2.5%) LEAs. Significant predictors (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05) of LEA in the final model adjusted for time\u2010updated measurements (hazard ratio, 95% CI) included age \u2265\u00a070\u00a0years (0.29, 0.08\u20130.97), prior amputation (2.31, 1.13\u20134.74), lower eGFR (1.16, 1.02\u20131.32), higher systolic blood pressure (1.40, 1.11\u20131.78), ABI\u00a0\u2264\u00a00.5 (3.94, 2.03\u20137.62), and incident DFU (10.44, 6.01\u201318.15).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this 12\u2010year prospective study, incident DFU emerged as having a substantial independent power in predicting LEA among other person\u2010 and limb\u2010specific risk factors. Preventing DFU occurrence is critical for reducing the burden of LEA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dmrr.70102","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T20:34:53Z","timestamp":1762202093000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association of Incident Diabetic Foot Ulcer With Lower\u2010Extremity Amputation Risk: The Prospective Seattle Diabetic Foot Study"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2423-4162","authenticated-orcid":false,"given":"Ibrahim S.","family":"Al\u2010Busaidi","sequence":"first","affiliation":[{"name":"Department of Primary Health Care Faculty of Medicine, University of Otago  Christchurch New\u00a0Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber D.","family":"Seelig","sequence":"additional","affiliation":[{"name":"Seattle Epidemiologic Research and Information Center VA Puget Sound Health Care System  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3695-192X","authenticated-orcid":false,"given":"Edward J.","family":"Boyko","sequence":"additional","affiliation":[{"name":"Seattle Epidemiologic Research and Information Center VA Puget Sound Health Care System  Seattle Washington USA"},{"name":"Department of Medicine University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11\u20101360"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1310799"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18\u20101380"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125\u2010018\u20104711\u20102"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.3471"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/diab.42.6.876"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.18.4.509"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.19.7.710"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.7.1029"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.8.1885"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2014.04.011"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17\u20102210"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci21\u20100026"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(24)00110\u20104"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/DC21\u20101816"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17\u20101836"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.13.5.513"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11\u20100807"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.18295\/squmj.2016.16.03.002"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125\u2010017\u20104488\u20108"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022\u20105347(06)00589\u20101"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc05\u20102031"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.19.2.165"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.7.1036"},{"issue":"2","key":"e_1_2_11_27_1","first-page":"1","article-title":"Aesthesiometry: Quantification of Cutaneous Pressure Sensation in Diabetic Peripheral Neuropathy","volume":"25","author":"Holewski J. 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