Skip to main content
Erschienen in: Diabetology International 3/2019

08.12.2018 | Short Communication

Clinical characteristics of Japanese diabetic patients with critical limb ischemia presenting Fontaine stage IV

verfasst von: Mitsuyoshi Takahara, Osamu Iida, Yukihiro Fujita, Masakazu Haneda

Erschienen in: Diabetology International | Ausgabe 3/2019

Einloggen, um Zugang zu erhalten

Abstract

The aim of the current study was to reveal the clinical characteristics of Japanese diabetic patients with critical limb ischemia (CLI) presenting ischemic unhealed ulcer/gangrene (Fontaine stage IV) in the real-world settings. The current retrospective cross-sectional study included consecutive 282 Japanese diabetic patients who underwent endovascular therapy for CLI presenting Fontaine stage IV. The prevalence of diabetes-related complications was estimated adopting multiple imputation (50 times). The patients were aged 70 ± 10 years. Median duration of diabetes was 21 (interquartile range 12–31) years. The prevalence of proliferative diabetic retinopathy, end-stage renal disease on regular dialysis, stroke, coronary artery disease, and chronic heart failure was estimated at 48% (95% confidence interval 39–56%), 52% (46–58%), 34% (28–39%), 48% (42–54%), and 35% (29–41%), respectively. The prevalence of stroke, coronary artery disease, and chronic heart failure was not significantly associated with the duration of diabetes (all p > 0.05). On the other hand, the prevalence of proliferative diabetic retinopathy and end-stage renal disease on regular dialysis was significantly positively associated with the duration of diabetes (both p < 0.05). However, these prevalences reached as high as ~ 30% even in patients with duration of diabetes < 10 years. In conclusion, the advanced stage of diabetes-related complications was prevalent in patients with CLI presenting Fontaine stage IV.
Literatur
1.
Zurück zum Zitat Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG, et al. Inter-society consensus for the management of peripheral arterial disease (TASC II). Eur J Vasc Endovasc Surg. 2007;33(Suppl 1):S1–75.CrossRef Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG, et al. Inter-society consensus for the management of peripheral arterial disease (TASC II). Eur J Vasc Endovasc Surg. 2007;33(Suppl 1):S1–75.CrossRef
2.
Zurück zum Zitat Iida O, Takahara M, Soga Y, Kodama A, Terashi H, Azuma N. Three-year outcomes of surgical versus endovascular revascularization for critical limb ischemia: the SPINACH study (Surgical Reconstruction Versus Peripheral Intervention in Patients With Critical Limb Ischemia). Circ Cardiovasc Interv. 2017;10:e005531.CrossRefPubMedPubMedCentral Iida O, Takahara M, Soga Y, Kodama A, Terashi H, Azuma N. Three-year outcomes of surgical versus endovascular revascularization for critical limb ischemia: the SPINACH study (Surgical Reconstruction Versus Peripheral Intervention in Patients With Critical Limb Ischemia). Circ Cardiovasc Interv. 2017;10:e005531.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Haneda M, Noda M, Origasa H, Noto H, Yabe D, Fujita Y, et al. Japanese clinical practice guideline for diabetes 2016. Diabetol Int. 2018;9:1–45.CrossRefPubMedPubMedCentral Haneda M, Noda M, Origasa H, Noto H, Yabe D, Fujita Y, et al. Japanese clinical practice guideline for diabetes 2016. Diabetol Int. 2018;9:1–45.CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Yokoyama H, Kawai K, Kobayashi M. Microalbuminuria is common in Japanese type 2 diabetic patients: a nationwide survey from the Japan Diabetes Clinical Data Management Study Group (JDDM 10). Diabetes Care. 2007;30:989–92.CrossRefPubMed Yokoyama H, Kawai K, Kobayashi M. Microalbuminuria is common in Japanese type 2 diabetic patients: a nationwide survey from the Japan Diabetes Clinical Data Management Study Group (JDDM 10). Diabetes Care. 2007;30:989–92.CrossRefPubMed
5.
Zurück zum Zitat Hayashino Y, Izumi K, Okamura S, Nishimura R, Origasa H, Tajima N. Duration of diabetes and types of diabetes therapy in Japanese patients with type 2 diabetes: the Japan Diabetes Complication and its Prevention prospective study 3 (JDCP study 3). J Diabetes Investig. 2017;8:243–9.CrossRefPubMed Hayashino Y, Izumi K, Okamura S, Nishimura R, Origasa H, Tajima N. Duration of diabetes and types of diabetes therapy in Japanese patients with type 2 diabetes: the Japan Diabetes Complication and its Prevention prospective study 3 (JDCP study 3). J Diabetes Investig. 2017;8:243–9.CrossRefPubMed
6.
Zurück zum Zitat Sone H, Katagiri A, Ishibashi S, Abe R, Saito Y, Murase T, et al. Effects of lifestyle modifications on patients with type 2 diabetes: the Japan Diabetes Complications Study (JDCS) study design, baseline analysis and 3 year-interim report. Horm Metab Res. 2002;34:509–15.CrossRefPubMed Sone H, Katagiri A, Ishibashi S, Abe R, Saito Y, Murase T, et al. Effects of lifestyle modifications on patients with type 2 diabetes: the Japan Diabetes Complications Study (JDCS) study design, baseline analysis and 3 year-interim report. Horm Metab Res. 2002;34:509–15.CrossRefPubMed
7.
Zurück zum Zitat Ueki K, Sasako T, Kato M, Okazaki Y, Okahata S, Katsuyama H, et al. Design of and rationale for the Japan Diabetes Optimal Integrated Treatment study for three major risk factors of cardiovascular diseases (J-DOIT3): a multicenter, open-label, randomized, parallel-group trial. BMJ Open Diabetes Res Care. 2016;4:e000123.CrossRefPubMedPubMedCentral Ueki K, Sasako T, Kato M, Okazaki Y, Okahata S, Katsuyama H, et al. Design of and rationale for the Japan Diabetes Optimal Integrated Treatment study for three major risk factors of cardiovascular diseases (J-DOIT3): a multicenter, open-label, randomized, parallel-group trial. BMJ Open Diabetes Res Care. 2016;4:e000123.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Uccioli L, Gandini R, Giurato L, Fabiano S, Pampana E, Spallone V, et al. Long-term outcomes of diabetic patients with critical limb ischemia followed in a tertiary referral diabetic foot clinic. Diabetes Care. 2010;33:977–82.CrossRefPubMedPubMedCentral Uccioli L, Gandini R, Giurato L, Fabiano S, Pampana E, Spallone V, et al. Long-term outcomes of diabetic patients with critical limb ischemia followed in a tertiary referral diabetic foot clinic. Diabetes Care. 2010;33:977–82.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Lejay A, Georg Y, Tartaglia E, Gaertner S, Geny B, Thaveau F, et al. Long-term outcomes of direct and indirect below-the-knee open revascularization based on the angiosome concept in diabetic patients with critical limb ischemia. Ann Vasc Surg. 2014;28:983–9.CrossRefPubMed Lejay A, Georg Y, Tartaglia E, Gaertner S, Geny B, Thaveau F, et al. Long-term outcomes of direct and indirect below-the-knee open revascularization based on the angiosome concept in diabetic patients with critical limb ischemia. Ann Vasc Surg. 2014;28:983–9.CrossRefPubMed
10.
Zurück zum Zitat Freisinger E, Malyar NM, Reinecke H, Lawall H. Impact of diabetes on outcome in critical limb ischemia with tissue loss: a large-scaled routine data analysis. Cardiovasc Diabetol. 2017;16:41.CrossRefPubMedPubMedCentral Freisinger E, Malyar NM, Reinecke H, Lawall H. Impact of diabetes on outcome in critical limb ischemia with tissue loss: a large-scaled routine data analysis. Cardiovasc Diabetol. 2017;16:41.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Noronen K, Saarinen E, Alback A, Venermo M. Analysis of the elective treatment process for critical limb ischaemia with tissue loss: diabetic patients require rapid revascularisation. Eur J Vasc Endovasc Surg. 2017;53:206–13.CrossRefPubMed Noronen K, Saarinen E, Alback A, Venermo M. Analysis of the elective treatment process for critical limb ischaemia with tissue loss: diabetic patients require rapid revascularisation. Eur J Vasc Endovasc Surg. 2017;53:206–13.CrossRefPubMed
12.
Zurück zum Zitat Meloni M, Izzo V, Giurato L, Del Giudice C, Da Ros V, Cervelli V, et al. Recurrence of critical limb ischemia after endovascular intervention in patients with diabetic foot ulcers. Adv Wound Care (New Rochelle). 2018;7:171–6.CrossRef Meloni M, Izzo V, Giurato L, Del Giudice C, Da Ros V, Cervelli V, et al. Recurrence of critical limb ischemia after endovascular intervention in patients with diabetic foot ulcers. Adv Wound Care (New Rochelle). 2018;7:171–6.CrossRef
13.
Zurück zum Zitat Yokoyama H, Matsushima M, Kawai K, Hirao K, Oishi M, Sugimoto H, et al. Low incidence of cardiovascular events in Japanese patients with type 2 diabetes in primary care settings: a prospective cohort study (JDDM 20). Diabet Med. 2011;28:1221–8.CrossRefPubMed Yokoyama H, Matsushima M, Kawai K, Hirao K, Oishi M, Sugimoto H, et al. Low incidence of cardiovascular events in Japanese patients with type 2 diabetes in primary care settings: a prospective cohort study (JDDM 20). Diabet Med. 2011;28:1221–8.CrossRefPubMed
14.
Zurück zum Zitat Faglia E, Dalla Paola L, Clerici G, Clerissi J, Graziani L, Fusaro M, et al. Peripheral angioplasty as the first-choice revascularization procedure in diabetic patients with critical limb ischemia: prospective study of 993 consecutive patients hospitalized and followed between 1999 and 2003. Eur J Vasc Endovasc Surg. 2005;29:620–7.CrossRefPubMed Faglia E, Dalla Paola L, Clerici G, Clerissi J, Graziani L, Fusaro M, et al. Peripheral angioplasty as the first-choice revascularization procedure in diabetic patients with critical limb ischemia: prospective study of 993 consecutive patients hospitalized and followed between 1999 and 2003. Eur J Vasc Endovasc Surg. 2005;29:620–7.CrossRefPubMed
15.
Zurück zum Zitat Fujishima M, Kiyohara Y, Kato I, Ohmura T, Iwamoto H, Nakayama K, et al. Diabetes and cardiovascular disease in a prospective population survey in Japan: the Hisayama study. Diabetes. 1996;45(Suppl 3):S14–6.CrossRefPubMed Fujishima M, Kiyohara Y, Kato I, Ohmura T, Iwamoto H, Nakayama K, et al. Diabetes and cardiovascular disease in a prospective population survey in Japan: the Hisayama study. Diabetes. 1996;45(Suppl 3):S14–6.CrossRefPubMed
16.
Zurück zum Zitat Nakagami T. Hyperglycaemia and mortality from all causes and from cardiovascular disease in five populations of Asian origin. Diabetologia. 2004;47:385–94.CrossRefPubMed Nakagami T. Hyperglycaemia and mortality from all causes and from cardiovascular disease in five populations of Asian origin. Diabetologia. 2004;47:385–94.CrossRefPubMed
17.
Zurück zum Zitat Kuwashiro T, Sugimori H, Ago T, Kuroda J, Kamouchi M, Kitazono T. The impact of predisposing factors on long-term outcome after stroke in diabetic patients: the Fukuoka Stroke Registry. Eur J Neurol. 2013;20:921–7.CrossRefPubMed Kuwashiro T, Sugimori H, Ago T, Kuroda J, Kamouchi M, Kitazono T. The impact of predisposing factors on long-term outcome after stroke in diabetic patients: the Fukuoka Stroke Registry. Eur J Neurol. 2013;20:921–7.CrossRefPubMed
18.
Zurück zum Zitat Kawasaki S, Misawa H, Tamura Y, Kondo Y, Satoh S, Hasegawa O, et al. Relationship between coronary artery disease and retinopathy in patients with type 2 diabetes mellitus. Intern Med. 2013;52:2483–7.CrossRefPubMed Kawasaki S, Misawa H, Tamura Y, Kondo Y, Satoh S, Hasegawa O, et al. Relationship between coronary artery disease and retinopathy in patients with type 2 diabetes mellitus. Intern Med. 2013;52:2483–7.CrossRefPubMed
19.
Zurück zum Zitat Tsuboi S, Miyauchi K, Kasai T, Ogita M, Dohi T, Miyazaki T, et al. Impact of red blood cell distribution width on long-term mortality in diabetic patients after percutaneous coronary intervention. Circ J. 2013;77:456–61.CrossRefPubMed Tsuboi S, Miyauchi K, Kasai T, Ogita M, Dohi T, Miyazaki T, et al. Impact of red blood cell distribution width on long-term mortality in diabetic patients after percutaneous coronary intervention. Circ J. 2013;77:456–61.CrossRefPubMed
Metadaten
Titel
Clinical characteristics of Japanese diabetic patients with critical limb ischemia presenting Fontaine stage IV
verfasst von
Mitsuyoshi Takahara
Osamu Iida
Yukihiro Fujita
Masakazu Haneda
Publikationsdatum
08.12.2018
Verlag
Springer Japan
Erschienen in
Diabetology International / Ausgabe 3/2019
Print ISSN: 2190-1678
Elektronische ISSN: 2190-1686
DOI
https://doi.org/10.1007/s13340-018-0387-6

Weitere Artikel der Ausgabe 3/2019

Diabetology International 3/2019 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.