Diabetic Foot Research Reveals Surprising Predictors of Healing and Amputation
February 18, 2026
The road to recovery from diabetic foot, a condition involving infection, ulceration or destruction of foot tissue in a person living with diabetes, may be less about income and education than previously believed.
A recent study found no measurable socio-economic influence on healing outcomes, while identifying hypertension as a significant predictor of readmission and recurrence.
The research, conducted under the Barbados Diabetic Foot Study (BDFS), was co-authored by Dr. Laura Lovell, Dr. Peter Chami, Professor Nachiappan Chockalingam, Nina Davies and Dr. Natalie Greaves. The wider BDFS initiative has already informed the development of a diabetic foot ulceration guide for primary care, along with a learning module. Both were piloted within the public primary healthcare system in 2025 to address gaps in clinical management and practitioner knowledge.
At the 13th Annual Faculty of Medical Sciences Graduate Symposium in January, Dr. Lovell, who is pursuing a PhD in Public Health, presented findings from a component of the research titled The Use of Machine Learning to Evaluate Risk Factors of a Cohort of Diabetic Foot Ulceration.
The research carries particular significance in Barbados, where an estimated one in five adults lives with diabetes and faces a lifetime risk of 19 to 34 per cent of developing a foot ulcer. Early detection and appropriate management are, therefore, critical.
For the aspect of the study presented by Dr. Lovell, data collection took place from 1 January 2024 to 30 June 2024. Artificial intelligence and machine learning were applied to predict outcomes for persons admitted at the hospital with diabetic foot ulcer during the period. Follow-up telephone interviews were conducted with the cohort at 52 weeks.
Participants had an average age of 68, with slightly more males than females recruited. Most participants were in lower income bands. Hypertension was the most common comorbidity in the sample, affecting 59 per cent of the cohort. Overall, 40.5 per cent had already undergone amputations, including nearly 26 per cent classified as minor.
By the end of one year recall, 68 per cent had achieved complete healing, while recurrence of foot ulcers was recorded in almost 20 per cent of cases. Mortality stood at 12 per cent.
Examining socio-economic factors, Dr. Lovell reported no measurable impact on healing or amputation outcomes.
“Although we’re seeing that most of the cohort has either welfare or lower socioeconomic grouping by income, it doesn’t actually change their healing effects at the 52-week recall or amputation risk”, she said.
Instead, clinical indicators proved more influential. The SINBAD score, a validated tool used to assess diabetic foot ulcers, emerged as the most significant predictor of amputation risk.
