Preventing recurrence after healing of diabetic foot ulcers (DFUs) remains a persistent clinical challenge, particularly during the remission phase, where ulcers are closed but the risk of recurrence continues. A systematic review published in Diabetology assessed recurrence occurring within 12 months among adults with diabetes following confirmed remission after DFU healing.
The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Literature searches were conducted across PubMed/MEDLINE, Scopus, ScienceDirect, and the Cochrane Library on December 16, 2025. Eligible studies included adults with diabetes in confirmed remission after DFU healing and provided a clearly defined 12-month recurrence outcome. Risk of bias was evaluated using the Critical Appraisal Skills Program and Joanna Briggs Institute tools, and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations framework.
Three cohorts met the inclusion criteria, contributing a total of 469 adults with confirmed remission at baseline and a defined 12-month outcome. The pooled recurrence proportion at 12 months was 29.3% (95% CI 24.9–34.1) using a random-effects model. This estimate was lower than the commonly cited ~40% recurrence at 1 year but reflects a narrowly defined remission population and a fixed 12-month assessment period rather than mixed follow-up intervals or broader definitions.
These findings indicate that approximately one in three adults in remission after a healed DFU experience recurrence within 12 months. However, the estimate is based on a limited number of cohorts and should be interpreted with caution and not generalized to all individuals with a healed DFU. The analysis supports the need for continued surveillance and risk management during remission. Larger, preregistered multicenter studies with standardized definitions are needed to better define short-term recurrence risk and inform survivorship-style models of care.
