Abstract
Diabetic foot disease (DFD) is a complication of diabetes mellitus, characterized by multiple pathogenetic factors, bearing a very high burden of disability as well as of direct and indirect costs for individuals or healthcare systems. A further characteristic of DFD is that it is associated with a marked risk of subsequent hospitalizations for incident cardiovascular events, chronic renal failure or of allcause mortality. Additionally, DFD is strongly linked to the male sex, being much more prevalent among men. However, even if DFD mainly affects males, several past reports suggest that females are disadvantaged as regards the risk of subsequent adverse outcomes. This review aims to clarify this point, attempting to provide an explanation for this apparent oddity: being DFD a typically male complication of diabetes but, seemingly, with a greater load of subsequent consequences for females.
Keywords: Diabetic foot disease, sex-gender differences, foot ulcers, cardiovascular complications, chronic renal failure, mortality.
[http://dx.doi.org/10.1002/dmrr.833] [PMID: 18442166]
[http://dx.doi.org/10.1016/S0140-6736(05)67698-2] [PMID: 16291066]
[http://dx.doi.org/10.1016/j.jvs.2010.06.003] [PMID: 20804928]
[PMID: 10655794]
[http://dx.doi.org/10.1007/s11892-019-1212-8] [PMID: 31456118]
[http://dx.doi.org/10.1001/jama.293.2.217] [PMID: 15644549]
[http://dx.doi.org/10.2337/diacare.26.2.491] [PMID: 12547887]
[http://dx.doi.org/10.1016/j.cpm.2019.02.002] [PMID: 31079602]
[http://dx.doi.org/10.2337/dc17-1836] [PMID: 29559450]
[http://dx.doi.org/10.2337/dc19-1614] [PMID: 32139380]
[http://dx.doi.org/10.1186/s13047-020-00383-2] [PMID: 32209136]
[http://dx.doi.org/10.1097/MD.0000000000011602] [PMID: 30075532]
[http://dx.doi.org/10.2337/dc12-1964] [PMID: 23970715]
[http://dx.doi.org/10.1016/j.ejvs.2013.04.013] [PMID: 23642521]
[http://dx.doi.org/10.2337/dc15-0989] [PMID: 26294664]
[http://dx.doi.org/10.1111/j.1464-5491.2011.03279.x] [PMID: 21388445]
[http://dx.doi.org/10.2147/CLEP.S146484] [PMID: 29719421]
[http://dx.doi.org/10.1136/bmjdrc-2019-000795] [PMID: 31749971]
[http://dx.doi.org/10.1371/journal.pone.0086405] [PMID: 24489723]
[http://dx.doi.org/10.1186/s12913-015-0687-5] [PMID: 25608648]
[http://dx.doi.org/10.1111/dme.12647] [PMID: 25439048]
[http://dx.doi.org/10.1016/j.avsg.2015.11.025] [PMID: 26907372]
[http://dx.doi.org/10.2337/dc13-2176] [PMID: 24186882]
[http://dx.doi.org/10.3310/hta19570] [PMID: 26211920]
[http://dx.doi.org/10.1007/s11883-017-0680-z] [PMID: 28971322]
[http://dx.doi.org/10.1016/j.ahj.2013.12.016] [PMID: 24655698]
[http://dx.doi.org/10.1136/bmj.h4865] [PMID: 26419648]
[http://dx.doi.org/10.1016/j.ijcard.2015.10.091] [PMID: 26512838]
[http://dx.doi.org/10.1186/s12933-016-0446-x] [PMID: 27590190]
[http://dx.doi.org/10.1155/2016/2879809] [PMID: 27213157]
[http://dx.doi.org/10.1007/s00125-008-0940-0] [PMID: 18297261]
[http://dx.doi.org/10.2174/1573399812666160517115756] [PMID: 27183843]
[http://dx.doi.org/10.1016/j.mam.2011.02.001] [PMID: 21356234]
[http://dx.doi.org/10.1210/er.2015-1137] [PMID: 27159875]
[http://dx.doi.org/10.1042/CS20160998] [PMID: 28424377]
[http://dx.doi.org/10.1186/s13293-019-0277-z] [PMID: 31900228]
[http://dx.doi.org/10.1016/S2213-8587(18)30079-2] [PMID: 29752194]
[http://dx.doi.org/10.1007/s11892-018-1005-5] [PMID: 29671082]
[http://dx.doi.org/10.1016/j.jdiacomp.2016.09.010] [PMID: 27746087]
[http://dx.doi.org/10.1001/archinte.158.6.617] [PMID: 9521226]
[http://dx.doi.org/10.1161/01.CIR.101.17.2040] [PMID: 10790344]
[http://dx.doi.org/10.1016/S0735-1097(01)01566-2] [PMID: 11691516]
[http://dx.doi.org/10.1016/j.ejogrb.2007.01.006] [PMID: 17324494]
[http://dx.doi.org/10.5694/mja2.50466] [PMID: 31886526]
[http://dx.doi.org/10.1007/s00125-012-2694-y] [PMID: 22945305]
[http://dx.doi.org/10.2337/dc13-0184] [PMID: 23835692]
[http://dx.doi.org/10.2337/diacare.21.8.1258] [PMID: 9702430]
[http://dx.doi.org/10.1016/j.numecd.2010.01.008] [PMID: 20621459]
[http://dx.doi.org/10.1007/s00125-011-2284-4] [PMID: 21861177]
[http://dx.doi.org/10.1016/j.numecd.2015.04.009] [PMID: 26033395]
[http://dx.doi.org/10.1007/s11999-010-1735-4] [PMID: 21161738]
[http://dx.doi.org/10.1161/CIR.0000000000000485] [PMID: 28122885]
[http://dx.doi.org/10.2337/dc19-2065] [PMID: 32499383]
[http://dx.doi.org/10.1111/dme.12196] [PMID: 23617411]
[http://dx.doi.org/10.1111/dme.12507] [PMID: 24863747]
[http://dx.doi.org/10.1067/mhj.2002.122871] [PMID: 12075249]
[http://dx.doi.org/10.1016/j.atherosclerosis.2011.08.037] [PMID: 21920520]
[http://dx.doi.org/10.1007/s00125-014-3260-6] [PMID: 24859435]
[http://dx.doi.org/10.1016/S0140-6736(14)60040-4] [PMID: 24613026]
[http://dx.doi.org/10.1253/circj.71.1131] [PMID: 17587723]
[PMID: 12669680]
[http://dx.doi.org/10.1007/s00592-019-01292-y] [PMID: 30725263]
[http://dx.doi.org/10.2147/DMSO.S51301] [PMID: 25258546]
[http://dx.doi.org/10.1007/s11883-015-0513-x] [PMID: 25939674]
[http://dx.doi.org/10.1016/j.jvs.2007.02.004] [PMID: 17543683]
[http://dx.doi.org/10.1161/CIR.0000000000000343] [PMID: 26644329]
[http://dx.doi.org/10.1016/j.jvs.2014.02.045] [PMID: 24703977]
[http://dx.doi.org/10.1016/j.jvs.2018.12.055] [PMID: 31543169]
[http://dx.doi.org/10.1016/j.numecd.2011.12.003] [PMID: 22397873]
[http://dx.doi.org/10.1016/j.metabol.2008.01.004] [PMID: 18442633]
[http://dx.doi.org/10.1093/ndt/gfn724] [PMID: 19131351]
[http://dx.doi.org/10.1007/s00592-019-01412-8] [PMID: 31468200]
[http://dx.doi.org/10.1097/HJH.0b013e3283495cd6] [PMID: 21738053]
[http://dx.doi.org/10.3390/jcm9061780] [PMID: 32521700]
[PMID: 23977409]