When two debilitating diseases collide: frailty and diabetic foot

The purpose of this study was to determine the frailty status and contributing factors of patients who presented to our department with diabetic foot (DF).

Between 1 January and 30 September 2023, consecutive patients <65 years of age who presented to our outpatient clinic with DF were included in this prospective study. The Clinical Frailty Scale (CFS) was used to measure frailty at the patients' initial appointment. Based on their CFS scores, the patients were divided into two groups: non-frail patients (with a level of 1-4); and frail patients (with a level of ≥5).

The median age of the 97 patients included in the study was 56 years, and median follow-up period was 3.8 months. Based on their CFS levels, 36 (37.1%) patients were defined as frail. There were considerably more patients in the frail group with Wagner stages 3 and 4 DF (p<0.001). More than half of patients in the frail group required a minor amputation for their DF (52.7% compared with 24.6% in the non-frail group; p=0.005).

DF is a debilitating disease which can lead to frailty, even in the non-geriatric population. Frailty is associated with an advanced stage of the disease and minor amputations in patients <65 years.