People with diabetes who develop active Charcot neuro-osteoarthropathy (CN) of the foot face substantial long-term risks of amputation and premature death, according to a retrospective single-center study published in Diabetes Therapy.

The analysis included 186 participants with type 1 or type 2 diabetes mellitus and 195 affected CN feet treated between January 2007 and September 2022 at a specialist foot clinic. Median follow-up was 8.2 years. Participant and CN-related characteristics associated with amputation and mortality were evaluated.

Findings

• Male sex (p=0.026) and previous amputation (p=0.003) were associated with higher amputation risk.
• Mortality rates were 2.7% (5/186) at 1 year, 18.9% (23/122) at 5 years, and 40.0% (24/60) at 10 years.
• Previous amputation was associated with higher mortality risk (p=0.005).
• Worsening chronic kidney disease (CKD) stage was associated with higher mortality risk (p=0.027).

Participants with active CN had high long-term mortality and amputation rates during follow-up. Previous amputation and worsening CKD stage were associated with higher mortality risk.