A systematic review and meta-analysis of glycemic control for the prevention of diabetic foot syndrome

Journal of Vascular Surgery
Rim HasanMohammad Hassan Murad

Abstract

The objective of this review was to synthesize the available randomized controlled trials (RCTs) estimating the relative efficacy and safety of intensive vs less intensive glycemic control in preventing diabetic foot syndrome. We used the umbrella design (systematic review of systematic reviews) to identify eligible RCTs. Two reviewers determined RCT eligibility and extracted descriptive, methodologic, and diabetic foot outcome data. Random-effects meta-analysis was used to pool outcome data across studies, and the I(2) statistic was used to quantify heterogeneity. Nine RCTs enrolling 10,897 patients with type 2 diabetes were included and deemed to be at moderate risk of bias. Compared with less intensive glycemic control, intensive control (hemoglobin A1c, 6%-7.5%) was associated with a significant decrease in risk of amputation (relative risk [RR], 0.65; 95% confidence interval [CI], 0.45-0.94; I(2) = 0%). Intensive control was significantly associated with slower decline in sensory vibration threshold (mean difference, -8.27; 95% CI, -9.75 to -6.79). There was no effect on other neuropathic changes (RR, 0.89; 95% CI, 0.75-1.05; I(2) = 32%) or ischemic changes (RR, 0.92; 95% CI, 0.67-1.26; I(2) = 0%). The quality of evidence ...Continue Reading

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Citations

Jun 28, 2016·Journal of Vascular Surgery·Michaela Beatrice RehmanRemy Boussageon
Jun 28, 2016·Journal of Vascular Surgery·M Hassan MuradBelal Firwana
Apr 18, 2018·Diabetes Care·Betiel K FessehaNestoras Mathioudakis
Nov 9, 2019·The International Journal of Lower Extremity Wounds·Eleni PapadokostakiEvangelos N Liberopoulos
Jul 16, 2020·Journal of Cardiovascular Pharmacology and Therapeutics·Emir M Muzurović, Dimitri P Mikhailidis
Oct 26, 2018·Cardiovascular Diabetology·Mathilde NativelKamel Mohammedi
Aug 18, 2020·Diabetology International·Eiichi ArakiNarihito Yoshioka
Nov 8, 2018·Evidence-based Complementary and Alternative Medicine : ECAM·Lizi TanJingbo Zhai
Oct 7, 2020·Journal of Diabetes Investigation·Eiichi ArakiNarihito Yoshioka
Dec 16, 2020·Diabetes, Obesity & Metabolism·Edward B JudeFernando Gomez-Peralta
Jan 26, 2021·Journal of Diabetes and Its Complications·Amélie SimoneauLaurence Blanco
Jan 3, 2021·Journal of Diabetes and Its Complications·Saad RojuballyVincent Rigalleau
Feb 23, 2021·Journal of Basic and Clinical Physiology and Pharmacology·Balamurugan RamanathanAswinram Balamurugan
May 20, 2021·Journal of Diabetes Science and Technology·Aaron DrovandiJonathan Golledge
Jul 20, 2021·The International Journal of Lower Extremity Wounds·Aditya DuttaAshu Rastogi
Jun 19, 2021·The International Journal of Lower Extremity Wounds·Mariana A BandeiraVera L C de Gouveia Santos
Sep 30, 2021·Diabetes/metabolism Research and Reviews·Puguang XieWuquan Deng

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