Demographic and Clinical Characteristics of Patients With Charcot Neuro-Osteoarthropathy in People With Diabetes Mellitus in Six Countries: A Multicenter Observational Study From 1996 to 2022.

T Tankova, N Tentolouris, A Rastogi, E B Jude, C Siafarikas, R Bem, M-F Kong, J LaFontaine, J Pappachan

Journal: Journal of diabetes research 2025;2025():4275741

PMID: 39817102

Abstract

To describe the demographic and clinical characteristics of patients with Charcot neuro-osteoarthropathy (CNO) and to examine for differences between participants with Type 1 diabetes mellitus (DM) (T1DM) and Type 2 diabetes mellitus (T2DM). Multicenter observational study in eight diabetic foot clinics in six countries between January 1, 1996, and December 31, 2022. Demographic, clinical, and laboratory parameters were obtained from the medical records. Analyses were performed using parametric or nonparametric statistical tests for variables with normally or nonnormally distributed values, respectively. Comparisons of the qualitative data were performed using the chi-square test. Seven hundred seventy-four patients with DM and CNO were included. The mean age at diagnosis of CNO was 54.5 ± 11.7 years, and the median (interquartile range (IQR)) diabetes duration at diagnosis of CNO was 15 (10-22) years. Among participants, 71.8% ( = 546) were male and 83.2% ( = 634) had T2DM. Neuropathy was present in 91.7% ( = 688), retinopathy in 60.2% ( = 452), and nephropathy in 45.2% ( = 337). Subjects with T1DM, compared to T2DM, were diagnosed with CNO at a younger age (46.9 ± 11.0 vs. 57.9 ± 10.2 years, < 0.001), had longer diabetes duration (median value (IQR): 29.0 (21.0-38.0) vs. 14.0 (8.0-20.0) years, < 0.001), and had more often microvascular complications (neuropathy, 95.2% in T1DM vs. 87.4% in T2DM, = 0.006; retinopathy, 83.3% vs. 55.4%, < 0.001; and nephropathy 67.5% vs. 40.5%, < 0.001). CNO is predominant in males, occurs in long-standing DM, and is often accompanied by microvascular complications. People with T1DM, compared to those with T2DM, are affected at a younger age, have longer diabetes duration, and have more often microvascular complications.

Copyright © 2025 E. B. Jude et al. Journal of Diabetes Research published by John Wiley & Sons Ltd.

Address: Department of Diabetes and Endocrinology, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton Under Lyne and University of Manchester and Manchester Metropolitan University, Manchester, UK.; First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece.; Diabetes and Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.; Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.; Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria.; Diabetes and Endocrinology, University Hospitals of Leicester NHS Trust, Leicester, UK.; UTRGV School of Podiatric Medicine, Department of Podiatric Medicine, Surgery and Biomechanics, Harlingen, Texas, USA.; Diabetes and Endocrinology, Lancashire Teaching Hospitals NHS Foundation Trust, Chorley, UK.
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