PDF(Pubmed)
Abstract：
UNASSIGNED: The metrics generated from continuous glucose monitoring (CGM), such as time in range (TIR), are strongly correlated with diabetes complications. This study explored the association of perioperative CGM-derived metrics with major amputation risk in patients with diabetic foot osteomyelitis (DFO).
UNASSIGNED: This study recruited 55 DFO patients with grade 3-4 wounds according to the Wagner Diabetic Foot Ulcer Classification System, all of whom underwent CGM for 5 days during the perioperative period. The CGM-derived metrics were defined in accordance with the most recent international consensus recommendations.
UNASSIGNED: Patients with major amputation had significantly less TIR and higher time below range (TBR) (all p < 0.05). In binary logistic regression analyses, a lower TIR was associated with the risk of major amputation (odds ratio: 0.83 (95% confidence interval: 0.71-0.99), p = 0.039). This association remained statistically significant after adjustments for age, sex, body mass index, type of diabetes, smoking, drinking, durations of diabetes and DFU, ankle-brachial index, albumin, estimated-glomerular filtration rate, Society for Vascular Surgery wound, ischemia, and foot infection (WIfi) stage, multidrug-resistant organisms, and hemoglobin A1c. Further adjustment for the mean amplitude of glycemic excursion (MAGE) reduced this association. TBR was also independently associated with the risk of major amputation (odds ratio: 1.60 (95% confidence interval: 1.17-2.18), p = 0.003); this association persisted after adjustment for MAGE.
UNASSIGNED: Perioperative TIR (3.9-10.0 mmol/L) and TBR (<3.9 mmol/L) were significantly associated with major amputation in hospitalized patients with DFO.
UNASSIGNED: This study recruited 55 DFO patients with grade 3-4 wounds according to the Wagner Diabetic Foot Ulcer Classification System, all of whom underwent CGM for 5 days during the perioperative period. The CGM-derived metrics were defined in accordance with the most recent international consensus recommendations.
UNASSIGNED: Patients with major amputation had significantly less TIR and higher time below range (TBR) (all p < 0.05). In binary logistic regression analyses, a lower TIR was associated with the risk of major amputation (odds ratio: 0.83 (95% confidence interval: 0.71-0.99), p = 0.039). This association remained statistically significant after adjustments for age, sex, body mass index, type of diabetes, smoking, drinking, durations of diabetes and DFU, ankle-brachial index, albumin, estimated-glomerular filtration rate, Society for Vascular Surgery wound, ischemia, and foot infection (WIfi) stage, multidrug-resistant organisms, and hemoglobin A1c. Further adjustment for the mean amplitude of glycemic excursion (MAGE) reduced this association. TBR was also independently associated with the risk of major amputation (odds ratio: 1.60 (95% confidence interval: 1.17-2.18), p = 0.003); this association persisted after adjustment for MAGE.
UNASSIGNED: Perioperative TIR (3.9-10.0 mmol/L) and TBR (<3.9 mmol/L) were significantly associated with major amputation in hospitalized patients with DFO.
摘要：
未经评估：连续血糖监测（CGM）生成的指标，例如范围内的时间(TIR)，与糖尿病并发症密切相关。这项研究探讨了围手术期CGM衍生指标与糖尿病足骨髓炎（DFO）患者主要截肢风险的关系。
UNASSIGNED：这项研究根据瓦格纳糖尿病足溃疡分类系统招募了55名3-4级伤口的DFO患者，所有患者在围手术期接受CGM5天.CGM衍生的指标是根据最新的国际共识建议定义的。
UNASSIGNED：大截肢患者的TIR明显减少，低于范围的时间（TBR）明显增多（均p<0.05）。在二元逻辑回归分析中，较低的TIR与严重截肢的风险相关(比值比:0.83(95%置信区间:0.71-0.99),p=0.039)。在调整年龄后，这种关联仍然具有统计学意义，性别,身体质量指数,糖尿病的类型,吸烟,饮酒,糖尿病和DFU的持续时间，踝臂指数,白蛋白,估计肾小球滤过率，血管外科创伤学会，缺血,和足部感染（WIfi）阶段，多药耐药生物，和血红蛋白A1c。对血糖波动的平均幅度(MAGE)的进一步调整减少了这种关联。TBR也与严重截肢的风险独立相关（比值比：1.60（95％置信区间：1.17-2.18），p=0.003）；在调整MAGE后，这种关联仍然存在。
UNASSIGNED：围手术期TIR（3.9-10.0mmol/L）和TBR（<3.9mmol/L）与DFO住院患者的大截肢明显相关。
UNASSIGNED：这项研究根据瓦格纳糖尿病足溃疡分类系统招募了55名3-4级伤口的DFO患者，所有患者在围手术期接受CGM5天.CGM衍生的指标是根据最新的国际共识建议定义的。
UNASSIGNED：大截肢患者的TIR明显减少，低于范围的时间（TBR）明显增多（均p<0.05）。在二元逻辑回归分析中，较低的TIR与严重截肢的风险相关(比值比:0.83(95%置信区间:0.71-0.99),p=0.039)。在调整年龄后，这种关联仍然具有统计学意义，性别,身体质量指数,糖尿病的类型,吸烟,饮酒,糖尿病和DFU的持续时间，踝臂指数,白蛋白,估计肾小球滤过率，血管外科创伤学会，缺血,和足部感染（WIfi）阶段，多药耐药生物，和血红蛋白A1c。对血糖波动的平均幅度(MAGE)的进一步调整减少了这种关联。TBR也与严重截肢的风险独立相关（比值比：1.60（95％置信区间：1.17-2.18），p=0.003）；在调整MAGE后，这种关联仍然存在。
UNASSIGNED：围手术期TIR（3.9-10.0mmol/L）和TBR（<3.9mmol/L）与DFO住院患者的大截肢明显相关。
