{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:18:03Z","timestamp":1790774283546,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,25]],"date-time":"2024-02-25T00:00:00Z","timestamp":1708819200000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023448","name":"Robert Koch Institut","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023448","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010215","name":"Deutsche Diabetes Gesellschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010215","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Diabetic foot ulcer (DFU) is a leading cause of lower limb amputations in people with diabetes. This study was aimed to retrospectively analyze factors affecting DFU using real\u2010world data from a large, prospective central\u2010European diabetes registry (DPV [Diabetes\u2010Patienten\u2010Verlaufsdokumentation]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We matched adults with type 1 (T1D) or type 2 diabetes (T2D) and DFU to controls without DFU by diabetes type, age, sex, diabetes duration, and treatment year to compare possible risk factors. Cox regression was used to calculate hazard ratios for amputation among those with DFU.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In our cohort (<jats:italic>N<\/jats:italic>\u2009=\u200963\u2009464), male sex, taller height, and diabetes complications such as neuropathy, peripheral artery disease, nephropathy, and retinopathy were associated with DFU (all <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Glycated hemoglobin (HbA1c) was related to DFU only in T1D (mean with 95% confidence interval [CI]: 7.8 [6.9\u20139.0] % vs 7.5 [6.8\u20138.5] %, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). High triglycerides and worse low\u2010density lipoprotein\/high\u2010density lipoprotein ratio were also associated with DFU in T1D, whereas smoking (14.7% vs 13.1%) and alcohol abuse (6.4% vs 3.8%, both <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) were associated with DFU in T2D. Male sex, higher Wagner grades, and high HbA1c in both diabetes types and insulin use in T2D were associated with increased hazard ratios for amputations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sex, body height, and diabetes complications were associated DFU risk in adults with T1D and T2D. Improvement in glycemic control and lipid levels in T1D and reduction of smoking and drinking in T2D may be appropriate interventions to reduce the risk for DFU or amputations.<\/jats:p><jats:p><jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/jdb13531-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/1753-0407.13531","type":"journal-article","created":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T01:35:23Z","timestamp":1708911323000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Factors associated with diabetic foot ulcers and lower limb amputations in type 1 and type 2 diabetes supported by real\u2010world data from the German\/Austrian DPV registry"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1239-3078","authenticated-orcid":false,"given":"Alexander J.","family":"Eckert","sequence":"first","affiliation":[{"name":"Institute of Epidemiology and Medical Biometry ZIBMT, University of Ulm  Ulm Germany"},{"name":"German Center for Diabetes Research (DZD)  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Zimny","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Endocrinology and Diabetology Helios Clinic Schwerin  Schwerin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Altmeier","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Diabetologie, Klinikum Dortmund  Dortmund Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Dugic","sequence":"additional","affiliation":[{"name":"Medical Clinic I, Klinikum Bayreuth Friedrich\u2010Alexander\u2010University Erlangen\u2010N\u00fcrnberg  Bayreuth Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Gillessen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Herz\u2010Jesu\u2010Hospital  Muenster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Latife","family":"Bozkurt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III and Karl Landsteiner Institute for Metabolic Disorders and Nephrology Clinic Hietzing, Vienna Health Care Group  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"G\u00f6tz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Diabetes, Gastroenterology, Tumor Medicine, and Palliative Care Academic Teaching Hospital N\u00fcrtingen  T\u00fcbingen 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