An observational study of foot ulceration risk in diabetic patients evaluated with autofluorescence: 195 cases cross-sectional and one-year outcome

To determine the risk factors of foot ulcers in diabetic patients indirectly via the measurement of advanced glycation end-products (AGE) with autofluorescence (AF). Between 2008 and 2009, a total of 195 diabetic inpatients, were recruited. Patients were categorized into those without foot ulcer, or with foot ulcer. Patients were followed up for 1 year via telephone and hospital visit. According to the first screening, mean values of skin AF were:2.29 ± 0.47 for subjects without foot ulcers and 2.80 ± 0.69 for those with foot ulcers, a significant difference(P < 0.05). Follow-up was conducted via telephone in 149 patients, and there were no significant changes in disease condition of both groups. Additionally, 34 patients were further followed-up via hospital visit. Each variable of these patients after follow-up was closely related to the corresponding one before follow-up (P < 0.05). Glycosylated hemoglobin (HbA1c) levels markedly declined, and high-density lipoprotein (HDL) cholesterol levels and VPT were significantly increased, after follow-up (P < 0.05). Moreover, there were no significant changes in AF value and ABI during follow-up. AF, which is associated with in vivo AGE levels, is also closely related to various risk factors of foot ulcers in diabetic patients. Our follow-up duration was relatively short, and thus, more studies with longer follow-up periods are warranted to confirm the role of AF as a risk factor for foot ulcers in diabetic patients.