{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:18:31Z","timestamp":1789561111146,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T00:00:00Z","timestamp":1712102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims\/Introduction<\/jats:title><jats:p>This study aimed to assess if patients can be divided into different strata, and to explore if these correspond to the risk of diabetic foot complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A set of 28 demographic, vascular, neurological and biomechanical measures from 2,284 (1,310\u00a0men, 974 women) patients were included in this study. A two\u2010step cluster analysis technique \u00a0was utilised to divide the patients into groups, each with similar characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Only two distinct groups: group\u20091 (<jats:italic>n<\/jats:italic>\u2009=\u20091,199; 669 men, 530 women) and group\u20092 (<jats:italic>n<\/jats:italic>\u2009=\u20091,072; 636 men, 436 women) were identified. From continuous variables, the most important predictors of grouping were: ankle vibration perception threshold (16.9\u2009\u00b1\u20094.1\u2009V vs 31.9\u2009\u00b1\u20097.4\u2009V); hallux vibration perception threshold (16.1\u2009\u00b1\u20094.7\u2009V vs 33.1\u2009\u00b1\u20097.9\u2009V); knee vibration perception threshold (18.2\u2009\u00b1\u20095.1\u2009V vs 30.1\u2009\u00b1\u20096.5\u2009V); average temperature sensation threshold to cold (29.2\u2009\u00b1\u20091.1\u00b0C vs 26.7\u2009\u00b1\u20090.7\u00b0C) and hot (35.4\u2009\u00b1\u20091.8\u00b0C vs 39.5\u2009\u00b1\u20091.0\u00b0C) stimuli, and average temperature tolerance threshold to hot stimuli at the foot (43.4\u2009\u00b1\u20090.9\u00b0C vs 46.6\u2009\u00b1\u20091.3\u00b0C). From categorical variables, only impaired sensation to touch was found to have importance at the highest levels: 87.4% of those with normal sensation were in group\u20091; whereas group\u20092 comprised 95.1%, 99.3% and 90.5% of those with decreased, highly\u2010decreased and absent sensation to touch, respectively. In addition, neuropathy (monofilament) was a moderately important predictor (importance level 0.52) of grouping with 26.2% of participants with neuropathy in group\u20091 versus 73.5% of participants with neuropathy in group\u20092. Ulceration during follow up was almost fivefold higher in group\u20092 versus group\u20091.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Impaired sensations to temperature, vibration and touch were shown to be the strongest factors in stratifying patients into two groups with one group having almost 5\u2010fold\u00a0risk of future foot ulceration compared to the other.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdi.14193","type":"journal-article","created":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T05:24:51Z","timestamp":1712208291000},"page":"1094-1104","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["What characteristics are most important in stratifying patients into groups with different risk of diabetic foot ulceration?"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2998-2883","authenticated-orcid":false,"given":"Roozbeh","family":"Naemi","sequence":"first","affiliation":[{"name":"School of Health Science and Wellbeing Staffordshire University  Stoke On Trent UK"},{"name":"School of Health and Society University of Salford  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nachiappan","family":"Chockalingam","sequence":"additional","affiliation":[{"name":"School of Health Science and Wellbeing Staffordshire University  Stoke On Trent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet K","family":"Lutale","sequence":"additional","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zulfiqarali G","family":"Abbas","sequence":"additional","affiliation":[{"name":"School of Health Science and Wellbeing Staffordshire University  Stoke On Trent UK"},{"name":"Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"},{"name":"Abbas Medical Centre  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.2.217"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13054"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.158.2.157"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13098-016-0126-8"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2014.07.021"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-010-2030-3"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta19570"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13797"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.05.017"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-2516(07)60001-5"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-0156"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2019.02.006"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2019-001122"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2013.08.004"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2021-002150"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1098\/rsta.2016.0293"}],"container-title":["Journal of Diabetes Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdi.14193","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T11:59:24Z","timestamp":1723204764000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdi.14193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,3]]},"references-count":16,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1111\/jdi.14193"],"URL":"https:\/\/doi.org\/10.1111\/jdi.14193","archive":["Portico"],"relation":{},"ISSN":["2040-1116","2040-1124"],"issn-type":[{"value":"2040-1116","type":"print"},{"value":"2040-1124","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,3]]},"assertion":[{"value":"2023-10-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}