{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T10:07:26Z","timestamp":1775729246462,"version":"3.50.1"},"reference-count":42,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Medical Research Council Research Training Fellowship","award":["MOH-000764-00"],"award-info":[{"award-number":["MOH-000764-00"]}]},{"name":"National Healthcare Group Population Health Grant","award":["PHG20\/S\/X\/1\/1"],"award-info":[{"award-number":["PHG20\/S\/X\/1\/1"]}]},{"name":"Skin Research Institute of Singapore, Agency for Science, Technology and Research","award":["H17\/01\/a0\/0Y9"],"award-info":[{"award-number":["H17\/01\/a0\/0Y9"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAPMA"],"abstract":"<jats:p>Background: Diabetic foot ulcers (DFUs) and lower-extremity amputations (LEAs) complicating diabetes mellitus are significant contributors to morbidity, mortality, and disease burden. There is insufficient evidence, however, linking podiatric care to mortality and healthcare resource use. There is, concurrently, inadequate access to podiatric care, particularly in Asia. This study evaluated the clinical and healthcare use outcomes of patients with DFUs who received podiatric care. Methods: A longitudinal study involving patients in Diabetic Foot in Primary and Tertiary (DEFINITE) Care followed over a period of 2 years reviewed the effectiveness of podiatric care with regard to 1-year outcomes using multiple logistic and zero-inflated negative binomial regressions, adjusting for covariates. Clinical outcomes were minor and major LEA, mortality, and LEA-free survival rates; healthcare use outcomes were the number of admissions, number of visits to clinics and emergency departments, and length of stay. Results: Eligible patients (n = 2798 [65.5%]) completed at least 12 months of follow-up. Comparisons were made with patients without access to podiatric care. The overall mean \u00b1 SD patient age was 65.7 \u00b1 12.7 years. Most patients receiving podiatric follow-up were of Malay or Indian ethnicities and had poor diabetic control and chronic kidney disease. There were more admissions (p &lt; 0.01) and visits to the emergency department (p &lt; 0.01) and hospital outpatient clinics (p &lt; 0.01), but a shorter length of stay (incidence rate ratio, 0.833; p &lt; 0.01), without any reported differences regarding visits to public primary care clinics (p = 0.68). There were more minor LEAs (p &lt; 0.01) but fewer deaths (p &lt; 0.01) and greater LEA-free survival (odds ratio, 1.26; p = 0.02). Conclusions: Podiatric care improved clinical outcomes for patients with DFU, particularly in terms of LEA-free survival, with a positive impact on healthcare utilization. This is a crucial contribution to the limited evidence on podiatric care in diabetic limb salvage in Asian populations.<\/jats:p>","DOI":"10.3390\/japma116010011","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T08:58:21Z","timestamp":1771837101000},"page":"11","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Podiatric Care Associated with Reduced Mortality and Enhanced Amputation-Free Survival"],"prefix":"10.3390","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9671-3421","authenticated-orcid":false,"given":"Wen","family":"Leo","sequence":"first","affiliation":[{"name":"Vascular Surgery Service, Department of Surgery, Woodlands Health, Singapore 737628, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8080-7020","authenticated-orcid":false,"given":"Lixia","family":"Ge","sequence":"additional","affiliation":[{"name":"Health Services and Outcome Research, National Healthcare Group, Singapore 138543, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chelsea","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Podiatry, Khoo Teck Puat Hospital, Singapore 768828, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiffany","family":"Chew","sequence":"additional","affiliation":[{"name":"Podiatry Service, Foot Care and Limb Design Centre, Tan Tock Seng Hospital, Singapore 308433, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo","family":"Lim","sequence":"additional","affiliation":[{"name":"Podiatry Service, Department of Rehabilitation, Woodlands Health, Singapore 737628, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elaine","family":"Tan","sequence":"additional","affiliation":[{"name":"National Healthcare Group Polyclinics, Singapore 308205, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0956-5759","authenticated-orcid":false,"given":"Huiling","family":"Liew","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Tan Tock Seng Hospital, Singapore 308433, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy","family":"Hoe","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Khoo Teck Puat Hospital, Singapore 768828, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaime","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Woodlands Health, Singapore 737628, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2289-5266","authenticated-orcid":false,"given":"Zhiwen","family":"Lo","sequence":"additional","affiliation":[{"name":"Vascular Surgery Service, Department of Surgery, Woodlands Health, Singapore 737628, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"ref_1","unstructured":"(2024, June 10). 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