TOPLINE:

Among patients with an incident diabetic foot ulcer, older age, hospital-acquired ulcers, and major comorbidities were associated with higher 1-year mortality, whereas the use of GLP‑1 receptor agonists and prior consultations with diabetologists, ophthalmologists, and podiatrists were associated with lower 1-year mortality.

METHODOLOGY:

• Researchers in France conducted a retrospective cohort study of 133,791 patients with diabetes and an incident diabetic foot ulcer (mean age, 72.7 years; 54.0% men) to identify factors associated with 1‑year mortality.
• Data on clinical characteristics, medication dispensations, and healthcare use were ascertained from linked nationwide databases and assessed in the 12 months before study entry.
• An incident diagnosis of a diabetic foot ulcer was defined as no prior diabetic foot ulcer and either a related hospitalisation or wound care reimbursements in the preceding year.
• The primary outcome was all-cause mortality within 1 year of the diagnosis of a diabetic foot ulcer; the secondary outcome was all-cause mortality within 1 year after a major amputation.

TAKEAWAY:

• During the 12 months after the diagnosis of a diabetic foot ulcer, 14.6% of patients died and 3.5% underwent a major amputation; among those who underwent a major amputation, 28.7% died within 1 year after the procedure.
• The strongest independent predictors of 1-year mortality after the diagnosis of a diabetic foot ulcer were older age (adjusted hazard ratio [aHR] per 10 years, 1.64), hospital-acquired diabetic foot ulcers (aHR, 2.16), and a major amputation (aHR, 1.16). Comorbidities associated with poor mortality outcomes were cardiovascular disease, active cancer, end‑stage kidney disease, Parkinson’s disease, dementia, and liver or exocrine pancreatic disease.
• The use of GLP‑1 receptor agonists and prior consultations with diabetologists, ophthalmologists, and podiatrists were each associated with reduced mortality.
• After major amputation, similar factors were associated with increased mortality; however, the use of GLP-1 receptor agonists showed a consistent protective effect.

IN PRACTICE:

“[The study] findings merit further validation and more detailed investigation in targeted subpopulations of people living with diabetes but should already motivate enhancements in care pathways at the territorial level,” the authors wrote.

SOURCE:

This study was led by Jean-Baptiste Bonnet, University Hospital of Montpellier, Montpellier, France. It was published online on January 30, 2026, in Diabetes Care.

LIMITATIONS:

Data on smoking status, blood pressure, and A1c and lipid levels were not available in the database. Moreover, the database could not reliably distinguish between type 1 and type 2 diabetes or determine precise disease duration. Finally, the medication data reflected dispensations rather than actual consumption.

DISCLOSURES:

This study was supported by grants from the Société Francophone de Diabétologie. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.