Evidence map›Paper›PMID 42290859›Full record

Observational studyFrontiers in endocrinology2026

Obstructive sleep apnea risk and its association with diabetic foot ulcer in patients with type 2 diabetes.

Raquel Ruano, María Teresa Charles, Josep León-Mengíbar, Ferran Barbé, Angel Michael Ortiz-Zúñiga, Marta Hernández, Cristina Hernández, Rafael Simó, Albert Lecube

Abstract readObservational Study
In one paragraph

Observational study in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Raquel RuanoDepartment of Endocrinology and Nutrition, University Hospital Arnau de Vilanova de Lleida, Obesity, Diabetes and Metabolism (ODIM) Research Group, Institute for Research in Biomedicine of Lleida (IRBLleida), University of Lleida, Lleida, Spain.
María Teresa CharlesDepartment of Endocrinology and Nutrition, University Hospital Arnau de Vilanova de Lleida, Obesity, Diabetes and Metabolism (ODIM) Research Group, Institute for Research in Biomedicine of Lleida (IRBLleida), University of Lleida, Lleida, Spain.
Josep León-MengíbarDepartment of Endocrinology and Nutrition, University Hospital Arnau de Vilanova de Lleida, Obesity, Diabetes and Metabolism (ODIM) Research Group, Institute for Research in Biomedicine of Lleida (IRBLleida), University of Lleida, Lleida, Spain.
Ferran BarbéTranslational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Institute for Research in Biomedicine of Lleida (IRBLleida), CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Lleida, Spain.
Angel Michael Ortiz-ZúñigaDepartment Endocrinology and Nutrition, University Hospital Vall d'Hebron. Diabetes and Metabolism Research Group, Vall d'Hebron Research Institute (VHIR), CIBERDEM (Institute of Health Carlos III), Barcelona, Spain.
Marta HernándezDepartment of Endocrinology and Nutrition, University Hospital Arnau de Vilanova de Lleida, Obesity, Diabetes and Metabolism (ODIM) Research Group, Institute for Research in Biomedicine of Lleida (IRBLleida), University of Lleida, Lleida, Spain.
Cristina HernándezDepartment Endocrinology and Nutrition, University Hospital Vall d'Hebron. Diabetes and Metabolism Research Group, Vall d'Hebron Research Institute (VHIR), CIBERDEM (Institute of Health Carlos III), Barcelona, Spain.
Rafael SimóDepartment Endocrinology and Nutrition, University Hospital Vall d'Hebron. Diabetes and Metabolism Research Group, Vall d'Hebron Research Institute (VHIR), CIBERDEM (Institute of Health Carlos III), Barcelona, Spain.
Albert LecubeDepartment Endocrinology and Nutrition, University Hospital Vall d'Hebron. Diabetes and Metabolism Research Group, Vall d'Hebron Research Institute (VHIR), CIBERDEM (Institute of Health Carlos III), Barcelona, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Obstructive sleep apnea (OSA) is common in type 2 diabetes (T2D) and may contribute to its chronic complications. Whether STOP-Bang-defined OSA risk is associated with diabetic foot ulcer (DFU) severity and outcome remains unclear. We compared STOP-Bang score between T2D patients with and without DFU and explored the association between OSA risk and DFU severity and healing. Methods: We conducted an observational study with a cross-sectional matched case-control comparison including 73 T2D patients with DFU and 73 T2D controls without DFU, matched by age, HbA1c, BMI and smoking. At the study visit, STOP-Bang-defined OSA risk was assessed as a continuous score and categorized as low versus moderate/high risk. In the DFU group, ulcer severity was graded at the same visit with the WIfI classification, and time to healing and amputation was recorded during clinical follow-up. Multivariable logistic regression identified predictors of moderate-to-high amputation risk. Results: In unadjusted analyses, DFU patients had higher STOP-Bang score than controls (4.3 ± 2.0 vs. 3.2 ± 2.2, p=0.004) and more often intermediate/high OSA risk (83.6% vs. 60.3%, p=0.002), although these differences were attenuated after accounting for sex imbalance. Among DFU patients, higher ulcer severity was associated with moderate/high STOP-Bang-defined OSA risk (97.1 vs. 71.8%; p=0.004). Median healing time was longer in those with moderate/high versus low STOP-Bang-defined OSA risk (120.0 vs. 65.0 days, p=0.032). In multivariable analysis, WIfI ulcer severity was associated with male sex, higher STOP-Bang category and poorer metabolic control. Conclusion: STOP-Bang-defined OSA risk was associated with greater DFU severity and delayed wound healing. Incorporating OSA risk stratification into routine assessment of patients with DFU may help identify individuals at higher risk of poor outcomes.

Indexed as

Diabetes Mellitus, Type 2Diabetic FootSleep Apnea, ObstructiveAgedCase-Control StudiesCross-Sectional StudiesFemaleHumansMaleMiddle AgedRisk FactorsSeverity of Illness IndexWound Healingamputation riskdiabetic foot ulcerobstructive sleep apneaSTOP-Bang questionnairetype 2 diabetes mellitusWIfI classification

Identifiers

PMID42290859
PMCPMC13259888

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.