Clinical trial NCT05491577: Factors Associated With an Evolution in the Quality of Life of Diabetic Patients With Chronic, Wound-free Charcot Foot
Official title: Factors Associated With Quality of Life Outcomes in Diabetic Patients With Chronic Wound-free Charcot Foot
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Charcot Joint of Foot
Osteoarthropathy
Keywords: Diabetes complications
Diabetic foot
Osteoarthropathy
Lead sponsor: Centre Hospitalier Universitaire de Nīmes
Sponsor class: OTHER
First posted: 2022-08-08
Enrollment: 150
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The source population corresponds to all diabetic patients (Type 1, 2 or secondary diabetes) hospitalized or consulting for chronic diabetic osteoarthropathy of the nerves, without wound managed in the participating centers.

Brief summary: Charcot foot, characterized by progressive destructive damage to bone, soft tissue and tendons, involving joint dislocation in the ankle and foot, is a complication of diabetes that is still poorly understood by patients and caregivers. The clinical signs are non-specific and it is therefore largely underestimated due to a delay in diagnosis/lack of diagnosis.This study will be on a prospective multicenter cohort of patients with chronic Charcot's foot in France to evaluate the evolution of quality of life at 2 years, as well as predictive factors in order to better identify subjects with the worst outcome among this population.

Our hypothesis is that, in patients with chronic Charcot foot, the deterioration in quality of life over time is primarily related to loss of foot and ankle functionality, foot and ankle deformity and the presence of foot wounds/comorbidities/severe diabetic complications.

Detailed description: Diabetes mellitus is a chronic disease, representing a major public health problem. An estimated 537 million people have diabetes. Charcot foot, also known as neurogenic osteoarthropathy (NAO), is one of the complications of diabetes secondary to diabetic neuropathy. It is characterized by progressive destructive damage to bone, soft tissue and tendons, involving joint dislocation in the ankle and foot. Charcot foot is a complication of diabetes that is still poorly understood by patients and caregivers, with non-specific clinical signs. It is therefore largely underestimated, since it is estimated that there is a delay in diagnosis or a lack of diagnosis in approximately 25% of cases.

The objective of our study is to conduct a prospective multicenter cohort of patients with chronic Charcot's foot in France in order to evaluate the evolution of the quality of life at 2 years, as well as its predictive factors. In this way, we will be better able to identify the subjects with the worst outcome among the chronic Charcot foot population.

Our hypothesis is that the deterioration in quality of life over time in patients with chronic Charcot foot is primarily related to loss of foot and ankle functionality, foot and ankle deformity, the presence of foot wounds and/or comorbidities or severe diabetic complications.

Eligibility criteria: Inclusion Criteria:

* patients with Type 1 or 2 diabetes or secondary diabetes
* patient hospitalized or consulting for osteoarthropathy in its chronic stage, without wounds
* patients affiliated to or beneficiaries of a health insurance scheme.
* adult patients (≥18 years old).

Exclusion Criteria:

* patients with non-diabetic osteoarthropathy of the nerves.
* patients with acute diabetic osteoarthropathy of the nerves.
* patients with a foot ulcer
* patients who have expressed opposition to participating in the study.
* patients in an exclusion period determined by another study.
* patients under court protection, guardianship or trusteeship.
* patients for whom it is impossible to give informed information.
* pregnant, parturient, or breastfeeding patients.

Primary outcomes:
measure: Results of the SF36 questionnaire at inclusion
timeFrame: Day 0
measure: Results of the FAAM-F questionnaire at inclusion
timeFrame: Day 0
measure: Results of the SF36 questionnaire at Month 12
timeFrame: Month 12
measure: Results of the FAAM-F questionnaire at Month 12
timeFrame: Month 12
measure: Results of the SF36 questionnaire at Month 24
timeFrame: Month 24
measure: Results of the FAAM-F questionnaire at Month 24
timeFrame: Month 24
Secondary outcomes:
measure: A. Evolution of X-ray measurements of bone and joint deformity of the foot. Lisfranc metatarsal misalignment (Méary's Line)
timeFrame: Day 0
measure: A. Evolution of X-ray measurements of bone and joint deformity of the foot. Lisfranc metatarsal misalignment (Méary's Line)
timeFrame: Month 12
measure: A. Evolution of X-ray measurements of bone and joint deformity of the foot. Lisfranc metatarsal misalignment (Méary's Line)
timeFrame: Month 24
measure: A. Evolution of the radiologic measurements of bone and joint deformity of the foot: Méary's angle.
timeFrame: Day 0
measure: A. Evolution of the radiologic measurements of bone and joint deformity of the foot: Méary's angle.
timeFrame: Month 12
measure: A. Evolution of the radiologic measurements of bone and joint deformity of the foot: Méary's angle.
timeFrame: Month 24
measure: A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Calcaneal slope
timeFrame: Day 0
measure: A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Calcaneal slope
timeFrame: Month 12
measure: A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Calcaneal slope
timeFrame: Month 24
measure: A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Djian Annonier angle
timeFrame: Day 0
measure: A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Djian Annonier angle
timeFrame: Month 12
measure: A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Djian Annonier angle
timeFrame: Month 24
measure: A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Rearfoot alignment
timeFrame: Day 0
measure: A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Rearfoot alignment
timeFrame: Month 12
measure: A. Evolution of the radiologic measurements of bone and joint deformity of the foot. Rearfoot alignment
timeFrame: Month 24
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Retinopathy
timeFrame: Month 24
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Retinopathy
timeFrame: Month 12
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Peripheral vegetative neuropathy.
timeFrame: Day 0
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Peripheral vegetative neuropathy.
timeFrame: Month 12
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Peripheral vegetative neuropathy.
timeFrame: Month 24
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Nephropathy.
timeFrame: Day 0
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Nephropathy.
timeFrame: Month 12
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Nephropathy.
timeFrame: Month 24
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Lower extremity arteriopathy
timeFrame: Day 0
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Lower extremity arteriopathy
timeFrame: Month 12
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Lower extremity arteriopathy
timeFrame: Month 24
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Supra-aortic trunk involvement
timeFrame: Day 0
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Supra-aortic trunk involvement
timeFrame: Month 12
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Supra-aortic trunk involvement
timeFrame: Month 24
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Coronary artery disease
timeFrame: Day 0
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Coronary artery disease
timeFrame: Month 12
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Coronary artery disease
timeFrame: Month 24
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Heart failure
timeFrame: Day 0
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Heart failure
timeFrame: Month 12
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Heart failure
timeFrame: Month 24
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. History of strokes
timeFrame: Day 0
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. History of strokes
timeFrame: Month 12
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. History of strokes
timeFrame: Month 24
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Arterial hypertension
timeFrame: Day 0
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Arterial hypertension
timeFrame: Month 12
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Arterial hypertension
timeFrame: Month 24
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Smoking
timeFrame: Day 0
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Smoking
timeFrame: Month 12
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Smoking
timeFrame: Month 24
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Alcohol status
timeFrame: Day 0
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Alcohol status
timeFrame: Month 12
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Alcohol status
timeFrame: Month 24
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Charlson Comorbidity Index
timeFrame: Day 0
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Charlson Comorbidity Index
timeFrame: Month 12
measure: B. Estimated prevalence of complications of diabetes and comorbidities at inclusion. Charlson Comorbidity Index
timeFrame: Month 24
measure: C. Medical and/or surgical treatment for Charcot foot.
timeFrame: Day 0
measure: C. Medical and/or surgical treatment for Charcot foot.
timeFrame: Month 12
measure: C. Medical and/or surgical treatment for Charcot foot.
timeFrame: Month 24
measure: D. Incidence of hospitalization
timeFrame: Month 12
measure: D. Incidence of hospitalization
timeFrame: Month 24
measure: E. Presence of a wound/wounds
timeFrame: Month 12
measure: E. Presence of a wound/wounds
timeFrame: Month 24
measure: E. Presence of an infection
timeFrame: Month 12
measure: E. Presence of an infection
timeFrame: Month 24
measure: F. Presence of an amputation at inclusion
timeFrame: Day 0
measure: G. Estimated incidence of amputations
timeFrame: Month 12
measure: G. Presence of an amputation
timeFrame: Month 24
measure: H. Precarity of patients with chronic Charcot foot.
timeFrame: Day 0
measure: H. Precarity of patients with chronic Charcot foot.
timeFrame: Month 12
measure: H. Precarity of patients with chronic Charcot foot.
timeFrame: Month 24
measure: I. Depression according to the PHQ-2 self-questionnaire
timeFrame: Day 0
measure: I. Depression according to the PHQ-2 self-questionnaire
timeFrame: Month 24
measure: I. Depression according to the PHQ-2 self-questionnaire
timeFrame: Month 12
measure: I. Depression according to the PHQ-9 self-questionnaire
timeFrame: Day 0
measure: I. Depression according to the PHQ-9 self-questionnaire
timeFrame: Month 12
measure: I. Depression according to the PHQ-9 self-questionnaire
timeFrame: Month 24
measure: J. Mortality rate
timeFrame: Month 12
measure: J. Mortality rate
timeFrame: Month 24
measure: K. Sanders Classification of the Charcot Foot
timeFrame: Day 0
measure: K. Sanders Classification of the Charcot Foot
timeFrame: Month 12
Other outcomes:
measure: Sex of patients
timeFrame: Day 0
measure: Age of patients
timeFrame: Day 0
measure: Patient's personal situation
timeFrame: Day 0
measure: Patient's personal situation
timeFrame: Month 12
measure: Patient's personal situation
timeFrame: Month 24
measure: Patient's level of education
timeFrame: Day 0
measure: Patient's level of education
timeFrame: Month 12
measure: Patient's level of education
timeFrame: Month 24
measure: Patient's professional activity
timeFrame: Day 0
measure: Patient's professional activity
timeFrame: Month 12
measure: Patient's professional activity
timeFrame: Month 24
measure: Nature of diabetes
timeFrame: Day 0
measure: Nature of diabetes
timeFrame: Month 12
measure: Nature of diabetes
timeFrame: Month 24
measure: Age of diabetes
timeFrame: Day 0
measure: Age of diabetes
timeFrame: Month 12
measure: Age of diabetes
timeFrame: Month 24
measure: Presence of other complications: Retinopathy
timeFrame: Day 0
measure: Presence of other complications: Retinopathy
timeFrame: Month 12
measure: Presence of other complications: Retinopathy
timeFrame: Month 24
measure: Presence of other complications: decreased visual acuity
timeFrame: Day 0
measure: Presence of other complications: decreased visual acuity
timeFrame: Month 12
measure: Presence of other complications: decreased visual acuity
timeFrame: Month 24
measure: Presence of other complications: Nephropathy
timeFrame: Day 0
measure: Presence of other complications: Nephropathy
timeFrame: Month 12
measure: Presence of other complications: Nephropathy
timeFrame: Month 24
measure: Presence of other complications: Abnormal glomerular filtration rate (GFR)
timeFrame: Day 0
measure: Presence of other complications: Abnormal glomerular filtration rate (GFR)
timeFrame: Month 12
measure: Presence of other complications: Abnormal glomerular filtration rate (GFR)
timeFrame: Month 24
measure: Presence of other complications: dialysis
timeFrame: Day 0
measure: Presence of other complications: dialysis
timeFrame: Month 12
measure: Presence of other complications: dialysis
timeFrame: Month 24
measure: Presence of other complications: peripheral neuropathy
timeFrame: Day 0
measure: Presence of other complications: peripheral neuropathy
timeFrame: Month 12
measure: Presence of other complications: peripheral neuropathy
timeFrame: Month 24
measure: Presence of other complications: vegetative neuropathy
timeFrame: Day 0
measure: Presence of other complications: vegetative neuropathy
timeFrame: Month 12
measure: Presence of other complications: vegetative neuropathy
timeFrame: Month 24
measure: Presence of other complications: coronaropathy
timeFrame: Day 0
measure: Presence of other complications: coronaropathy
timeFrame: Month 12
measure: Presence of other complications: coronaropathy
timeFrame: Month 24
measure: Presence of other complications: heart failure
timeFrame: Day 0
measure: Presence of other complications: heart failure
timeFrame: Month 12
measure: Presence of other complications: heart failure
timeFrame: Month 24
measure: Presence of other complications: arteriopathy of the lower limbs
timeFrame: Day 0
measure: Presence of other complications: arteriopathy of the lower limbs
timeFrame: Month 12
measure: Presence of other complications: arteriopathy of the lower limbs
timeFrame: Month 24
measure: Presence of other complications: involvement of the supra-aortic trunk
timeFrame: Day 0
measure: Presence of other complications: involvement of the supra-aortic trunk
timeFrame: Month 12
measure: Presence of other complications: involvement of the supra-aortic trunk
timeFrame: Month 24
measure: Presence of other complications: stroke
timeFrame: Day 0
measure: Presence of other complications: stroke
timeFrame: Month 12
measure: Presence of other complications: stroke
timeFrame: Month 24
measure: Presence of other complications: sequellar hemiplegia
timeFrame: Day 0
measure: Presence of other complications: sequellar hemiplegia
timeFrame: Month 12
measure: Presence of other complications: sequellar hemiplegia
timeFrame: Month 24
measure: Treatments: oral antidiabetics
timeFrame: Day 0
measure: Treatments: oral antidiabetics
timeFrame: Month 12
measure: Treatments: oral antidiabetics
timeFrame: Month 24
measure: Treatments: injectable antidiabetics
timeFrame: Day 0
measure: Treatments: injectable antidiabetics
timeFrame: Month 12
measure: Treatments: injectable antidiabetics
timeFrame: Month 24
measure: Other treatments
timeFrame: Day 0
measure: Other treatments
timeFrame: Month 12
measure: Other treatments
timeFrame: Month 24
measure: History of trophic disorders
timeFrame: Day 0
measure: History of trophic disorders
timeFrame: Month 12
measure: History of trophic disorders
timeFrame: Month 24
measure: Regular pedicure treatments
timeFrame: Day 0
measure: Regular pedicure treatments
timeFrame: Month 12
measure: Regular pedicure treatments
timeFrame: Month 24
measure: Weight
timeFrame: Day 0
measure: Weight
timeFrame: Month 12
measure: Weight
timeFrame: Month 24
measure: Height
timeFrame: Day 0
measure: Height
timeFrame: Month 12
measure: Height
timeFrame: Month 24
measure: Charcot foot
timeFrame: Day 0
measure: Charcot foot
timeFrame: Month 12
measure: Charcot foot
timeFrame: Month 24
measure: Estimated age of lesions (deformities) caused by neurogenic osteoarthropathy
timeFrame: Day 0
measure: Estimated age of lesions (deformities) caused by neurogenic osteoarthropathy
timeFrame: Month 12
measure: Estimated age of lesions (deformities) caused by neurogenic osteoarthropathy
timeFrame: Month 24
measure: Neurogenic osteoarthropathy Sanders classification
timeFrame: Day 0
measure: Neurogenic osteoarthropathy Sanders classification
timeFrame: Month 12
measure: Neurogenic osteoarthropathy Sanders classification
timeFrame: Month 24
measure: Current mode of shoeing/unfastening at home
timeFrame: Day 0
measure: Current mode of shoeing/unfastening outdoors
timeFrame: Day 0
measure: Current mode of shoeing/unfastening at home
timeFrame: Month 12
measure: Current mode of shoeing/unfastening outdoors
timeFrame: Month 12
measure: Current mode of shoeing/unfastening at home
timeFrame: Month 24
measure: Current mode of shoeing/unfastening outdoors
timeFrame: Month 24
measure: Adherence to shoeing method
timeFrame: Day 0
measure: Adherence to shoeing method
timeFrame: Month 12
measure: Adherence to shoeing method
timeFrame: Month 24
measure: Presence of another trophic foot disorder during the previous year
timeFrame: Day 0
measure: Presence of another trophic foot disorder during the previous year
timeFrame: Month 12
measure: Presence of another trophic foot disorder during the previous year
timeFrame: Month 24
measure: Presence of a clinical infection
timeFrame: Day 0
measure: Presence of a clinical infection
timeFrame: Month 12
measure: Presence of a clinical infection
timeFrame: Month 24
measure: Foot or leg surgery in the previous year
timeFrame: Day 0
measure: Foot or leg surgery in the previous year
timeFrame: Month 12
measure: Foot or leg surgery in the previous year
timeFrame: Month 24
measure: Partial foot amputation
timeFrame: Day 0
measure: Partial foot amputation
timeFrame: Month 12
measure: Partial foot amputation
timeFrame: Month 24
measure: Trans-tibial amputation
timeFrame: Day 0
measure: Trans-tibial amputation
timeFrame: Month 12
measure: Trans-tibial amputation
timeFrame: Month 24
measure: Trans-femoral amputation
timeFrame: Day 0
measure: Trans-femoral amputation
timeFrame: Month 12
measure: Trans-femoral amputation
timeFrame: Month 24
measure: Other type of surgery
timeFrame: Day 0
measure: Other type of surgery
timeFrame: Month 12
measure: Other type of surgery
timeFrame: Month 24
measure: Hospitalization in the previous year
timeFrame: Day 0
measure: Hospitalization in the previous year
timeFrame: Month 12
measure: Hospitalization in the previous year
timeFrame: Month 24
measure: Onset and management of a foot wound (medical or surgical)
timeFrame: Day 0
measure: Onset and management of a foot wound (medical or surgical)
timeFrame: Month 12
measure: Onset and management of a foot wound (medical or surgical)
timeFrame: Month 24
measure: Management of a Charcot foot
timeFrame: Day 0
measure: Management of a Charcot foot
timeFrame: Month 12
measure: Management of a Charcot foot
timeFrame: Month 24
measure: Onset of a controlateral Charcot foot
timeFrame: Day 0
measure: Onset of a controlateral Charcot foot
timeFrame: Month 12
measure: Onset of a controlateral Charcot foot
timeFrame: Month 24
measure: Diabetic imbalance
timeFrame: Day 0
measure: Diabetic imbalance
timeFrame: Month 12
measure: Diabetic imbalance
timeFrame: Month 24
measure: Other comorbidity or other reason for surgery
timeFrame: Day 0
measure: Other comorbidity or other reason for surgery
timeFrame: Month 12
measure: Other comorbidity or other reason for surgery
timeFrame: Month 24
measure: Monitoring of glycemic control by HbA1c
timeFrame: Day 0
measure: Monitoring of glycemic control by HbA1c
timeFrame: Month 12
measure: Monitoring of glycemic control by HbA1c
timeFrame: Month 24
measure: Monitoring of glomerular Filtration Rate
timeFrame: Day 0
measure: Monitoring of glomerular Filtration Rate
timeFrame: Month 12
measure: Monitoring of glomerular Filtration Rate
timeFrame: Month 24
measure: X-ray of Charcot foot under loading (profile view)
timeFrame: Day 0
measure: X-ray of Charcot foot under loading (profile view)
timeFrame: Month 12
measure: X-ray of Charcot foot under loading (profile view)
timeFrame: Month 24
measure: Front view X-ray of the ankle(s) under loading
timeFrame: Day 0
measure: Front view X-ray of the ankle(s) under loading
timeFrame: Month 12
measure: Front view X-ray of the ankle(s) under loading
timeFrame: Month 24
Locations:
city: Boulogne-sur-Mer
country: France
facility: Centre Hospitalier de Boulogne-sur-Mer
state: Pas-de-Calais
city: Bron
country: France
facility: Groupement Hospitalier Est, Hôpital Cardiologique Service de Diabétologie 28 Av du Doyen Lépine
city: Corbeil-Essonnes
country: France
facility: CH Sud Francilien Service de Diabétologie 40 Avenue Serge Dassault
city: Grenoble
country: France
facility: CHU de Grenoble Service d'Endocrinologie Allée des Sablons Les écrins
city: Le Creusot
country: France
facility: Hôpital Hôtel dieu Service d'Endocrinologie 26 rue d'Harfleur
city: Le Kremlin-Bicêtre
country: France
facility: CHU Bicêtre Service d'Endocrinologie et Maladies de la reproduction 78 rue du Général Leclerc
city: Lens
country: France
facility: CH de Lens Unité de Diabétologie-Endocrinologie- Nutrition-Obésité Centre Hospitalier Dr SCHAFFNER 99 rte de La Bassée,
city: Lille
country: France
facility: CHRU de Lille Service d'Endocrinologie Diabétologie et Métabolisme, Hôpital Claude Huriez, Rue Polonovski
city: Marseille
country: France
facility: CHU de la CONCEPTION Service de Nutrition, Diabétologie, Obésité médicale, chirurgicale 47 Bd Baille
city: Montpellier Cedex
country: France
facility: CHU de Montpellier Service des Maladies métaboliques 371 av. Doyen Giraud
city: Paris
country: France
facility: GH Pitié Salpétrière Unité de podologie Service de Diabétologie 47-83 Bd de l'Hôpital
city: Paris
country: France
facility: GH Paris Saint Joseph Service de Diabétologie et Endocrinologie 185 rue Raymond Losserand
city: Paris
country: France
facility: Hôpital Cochin Service de diabétologie 123 Bd de Port Royal
city: Pierre-Bénite
country: France
facility: CHU de Lyon Sud Service d'Endocrinologie-Diabète-Nutrition CH Lyon Sud Pavillon médical, Bat 1B 165 chemin du Grand Revoyet
city: Reims
country: France
facility: CHU Reims Service d'Endocrinologie, diabète-nutrition Rue du Général Koenig
city: Strasbourg
country: France
facility: Hôpitaux Universitaires de Strasbourg Service d'Endocrinologie et Diabétologie 1, place de l'hôpital,
city: Tourcoing
country: France
facility: Hôpital DRON Service de diabétologie 135 rue du Président Coty
Study officials:
References: