Persistent medication adherence and lifestyle changes compliance in patients with type 2 diabetes undergoing minor foot amputation and one-year all-cause mortality

Abstract Background The 3-years mortality rate in patients with Type 2 diabetes (T2D) after minor amputations may reach 53–80%. aim of the study was to evaluate impact persistent medication adherence and compliance lifestyle recommendations on 1-year all-cause T2D peripheral artery disease (PAD) foot amputation. Methods This is a prospective, single-center, observational cohort including 785 consecutive PAD undergoing followed-up over 1 year (mean age 62.3±7.2 years; 62.8% males). Based compliance, were divided into 4 groups: adherent/compliant (n=432), adherent/non-compliant (n=101), compliant/non-adherent (n=68), non-adherent/non-compliant (n=184). Secondary prevention included healthy diet, smoking cessation, physical exercise ≥30 min/day >80% drug intake (wound healing, antidiabetic, cardiovascular treatment, dual antiplatelet statin treatment). Cox proportional hazard models used examine how variables predict one-year mortality. Results One-year 16.9% (n=133) at follow-up (Figure 1). After adjusting for confounders, compared patients, all other groups had an increased risk In HR=9.08 [95% CI 5.55, 14.86], p<0.001; HR=3.86 (95% [2.08, 7.14], p<0.001), non-adherent/compliant HR=2.98 [1.45, 6.08] p=0.003). adjustment, age, history myocardial infarction, infection also remained significant 2). Conclusion who persistently non-adherent non-compliant changes nine-fold PFA, non-compliance only 3.8-fold, non-adherence – 3.0-fold, which outline importance secondary preventive measures. Funding Acknowledgement funding sources: None.