Gender difference as the risk of diabetic foot ulcers in T2DM patients: a meta-analysis

To investigate the gender difference as a risk factor of diabetic foot ulcer (DFU) in diabetes mellitus type 2 (T2DM) patients.The online databases including China National Knowledge Infrastructure (CNKI), Wanfang, China Biomedical Literature, PubMed, Embase, Web of Science, and Cochrane Library were searched.The retrospective and prospective studies published on the gender difference as risk factor of DFU were accessed from the databases and analyzed by the STATA software.Two prospective and 7 retrospective studies involving 4399 DFU patients were included.The results exhibited that being male (odd ratio (OR) = 1.74, 95% Confidence interval, confidence interval (CI): 1.55-1.96,p = 0.0001) was a statistically significant risk factor of DFU in T2DM patients.Other risk factors were the age of >60 years (OR = 3.12, 95% CI: 2.16-4.49,p = 0.0001), smoking (OR = 4.32, 95% CI: 3.13-5.68,p = 0.0001), hypertension (OR = 2.18, 95% CI: 1.39-3.87,p = 0.0001), cerebrovascular event (OR = 2.16, 95% CI: 1.88-3.98,p = 0.0001), coronary artery disease (OR = 1.16, 95% CI: 1.05-1.96,p = 0.0001), chronic renal failure (OR = 2.21, 95% CI: 1.54-2.79,p = 0.001), and Glycosylated hemoglobin (HbA1c) ≥7 (OR = 3.56, 95% CI: 2.27-4.43,p = 0.001).Furthermore, insulin treatment was the protective factor of DFU in male (OR = 0.66, 95% CI: 0.38-0.93,p = 0.001) and female (OR = 0.44, 95% CI: 0.27-0.83,p = 0.003) T2DM patients.Male, age >60 years, smoking, hypertension, coronary artery disease, chronic renal failure, and HbA1c ≥7 were the risk factors of DFU in T2DM patients.The publicity and awareness regarding these risk factors should be strengthened in the future clinical practice.Regular screening of high-risk groups be carried out for early detection and treatment.