{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:58:34Z","timestamp":1792511914107,"version":"4.5.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T00:00:00Z","timestamp":1613606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Diabetes mellitus is associated with serious complications, with foot ulcers and amputation of limbs among the most debilitating consequences of late diagnosis and treatment of foot ulcers. Thus, prediction and on-time treatment of diabetic foot ulcers (DFU) are of great importance for improving and maintaining patients' quality of life and avoiding the consequent socio-economical burden of amputation. In this study, we use Danish national registry data to understand the risk factors of developing diabetic foot ulcers and amputation among patients with diabetes. We analyze the data of 246,705 patients with diabetes to assess some of the main risk factors for developing DFU\/amputation. We study the socioeconomic information and past medical history of the patients. Factors, such as low family disposable income, cardiovascular disorders, peripheral artery, neuropathy, and chronic renal complications are among the important risk factors. Mental disorders and depression, albeit not as pronounced, still pose higher risks in comparison to the group of people without these complications. We further use machine learning techniques to assess the practical usefulness of such risk factors for predicting foot ulcers and amputation. Finally, we outline the limitations of working with registry data sources and explain potentials for combining additional public and private data sources in future applications of artificial intelligence (AI) to improve the prediction of diabetic foot ulcers and amputation.<\/jats:p>","DOI":"10.3389\/fmed.2020.601602","type":"journal-article","created":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T15:28:09Z","timestamp":1613834889000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":40,"title":["Toward Machine-Learning-Based Decision Support in Diabetes Care: A Risk Stratification Study on Diabetic Foot Ulcer and Amputation"],"prefix":"10.3389","volume":"7","author":[{"given":"Zeinab","family":"Sch\u00e4fer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Mathisen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrine","family":"Svendsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Engberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trine","family":"Rolighed Thomsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Kirketerp-M\u00f8ller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,2,18]]},"reference":[{"key":"B1","unstructured":"2019"},{"key":"B2","doi-asserted-by":"publisher","first-page":"136","DOI":"10.2337\/dc16-2042","article-title":"Diabetic neuropathy: a position statement by the American Diabetes Association","volume":"40","author":"Pop-Busui","year":"2017","journal-title":"Diabetes Care"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1435","DOI":"10.2337\/diacare.26.5.1435","article-title":"Diabetic foot syndrome: evaluating the prevalence and incidence of foot pathology in Mexican Americans and non-Hispanic whites from a diabetes disease management cohort","volume":"26","author":"Lavery","year":"2003","journal-title":"Diabetes Care"},{"key":"B4","doi-asserted-by":"publisher","first-page":"309","DOI":"10.2217\/dmt.12.34","article-title":"Diabetes prevention: global health policy and perspectives from the ground","volume":"2","author":"Bergman","year":"2012","journal-title":"Diabetes Manage"},{"key":"B5","first-page":"1","article-title":"The management of diabetic foot ulcers in Danish hospitals is not optimal","volume":"62","author":"Kirketerp-M\u00f8ller","year":"2015","journal-title":"Danish Med J"},{"key":"B6","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1111\/dme.12965","article-title":"Health economics societal costs of diabetes mellitus in Denmark","volume":"33","author":"Sorts\u00f8","year":"2015","journal-title":"Diabetic Med J"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1417","DOI":"10.1111\/dme.13964","article-title":"Incidence and predictors of recurrent and other new diabetic foot ulcers: a retrospective cohort study","volume":"36","author":"Engberg","year":"2019","journal-title":"Diabet Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.diabres.2019.04.021","article-title":"Standard complication screening information can be used for risk assessment for first time foot ulcer among patients with type 1 and type 2 diabetes","volume":"151","author":"Hangaard","year":"2019","journal-title":"Diabetes Res Clin Pract"},{"key":"B9","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1093\/occmed\/kqh047","article-title":"Do stressful life events cause type 1 diabetes?","volume":"54","author":"Cosgrove","year":"2004","journal-title":"Occupat Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1186\/1472-6963-6-124","article-title":"Association of socio-economic status with diabetes prevalence and utilization of diabetes care services","volume":"6","author":"Rabi","year":"2006","journal-title":"BMC Health Serv Res"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2286","DOI":"10.2337\/dc11-2052","article-title":"Poverty increases type 2 diabetes incidence and inequality of care despite universal health coverage","volume":"35","author":"Hsu","year":"2012","journal-title":"Diabetes Care"},{"key":"B12","first-page":"112","article-title":"Does emotional stress cause type 2 diabetes mellitus? 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