Diabetic foot epidemiology and demographics: Difference between revisions

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__NOTOC__
__NOTOC__
{{Diabetic foot}}
{{Diabetic foot}}
{{Diabetes mellitus }}
{{CMG}} {{AE}} {{Anahita}} {{VVS}} {{USAMA}}
{{CMG}} {{AE}} {{VVS}}
 
==Overview==
The [[incidence]] of [[diabetic foot]] [[ulcer]] is approximately 1500 per 100,000 [[diabetes|diabetic]] individuals world wide. Among the US veterans the [[incidence]] of active [[diabetic foot]] [[ulcers]] is approximately 500 per 100,000 individuals. On the other hand the [[incidence]] of active [[diabetic foot]] [[ulcers]] in United Kingdom has been estimated 220 per 100,000 individuals. Furthermore it's [[prevalence]] has been reported 170 per 100,000 individuals among the United Kingdom population. The 5 year risk of [[mortality rate|mortality]] in [[diabetes|diabetic]] [[patient|patients]] with a [[foot]] [[ulcer]] is 2.5 times higher than [[diabetes|diabetic individuals]] without a [[foot]] [[ulcer]]. Based on 2 studies with different follow up duration, [[mortality rate]] of [[diabetic foot]] has been estimated as 10% and 24% in 16 months and 5 years follow up, respectively. Based on a [[systematic review]] and [[Meta-analysis|metanalysis]] done on [[diabetes]] [[patients]], [[diabetic foot]] was more common among older [[patients]]. White people develop [[diabetes|diabetic]] [[peripheral neuropathy]] (which is a serious [[risk factor]] for [[diabetic foot]]) more frequently. In 1987, Borch-Johnsen et al. described a [[male]] preponderance for the development of severe [[Microvascular disease|microvascular]] [[Complication (medicine)|complications]] and [[diabetic foot]] [[disease]] is not an exception to this rule. Highest [[prevelance]] of [[diabetic foot]] has been reported in North America. In contrast, Oceania has the lowest reported [[prevelance]] of [[diabetic foot]].
 
==Epidemiology and Demographics==
==Epidemiology and Demographics==
===Incidence===
===Incidence===
It has been reported that annually, about 1 to 4 percent of those with diabetes develop a foot ulcer; 10 to 15 percent of those with diabetes will have at least one foot ulcer during their lifetime.<ref name="pmid17280936">{{cite journal| author=Frykberg RG, Zgonis T, Armstrong DG, Driver VR, Giurini JM, Kravitz SR et al.| title=Diabetic foot disorders. A clinical practice guideline (2006 revision). | journal=J Foot Ankle Surg | year= 2006 | volume= 45 | issue= 5 Suppl | pages= S1-66 | pmid=17280936 | doi=10.1016/S1067-2516(07)60001-5 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17280936  }} </ref>
*The [[incidence]] of [[diabetic foot]] [[ulcer]] is approximately 630 per 100,000 [[diabetes|diabetic]] individuals world wide.<ref name="pmid28614678">{{cite journal| author=Armstrong DG, Boulton AJM, Bus SA| title=Diabetic Foot Ulcers and Their Recurrence. | journal=N Engl J Med | year= 2017 | volume= 376 | issue= 24 | pages= 2367-2375 | pmid=28614678 | doi=10.1056/NEJMra1615439 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28614678  }} </ref><ref name="pmid12027925">{{cite journal| author=Abbott CA, Carrington AL, Ashe H, Bath S, Every LC, Griffiths J et al.| title=The North-West Diabetes Foot Care Study: incidence of, and risk factors for, new diabetic foot ulceration in a community-based patient cohort. | journal=Diabet Med | year= 2002 | volume= 19 | issue= 5 | pages= 377-84 | pmid=12027925 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12027925  }} </ref><ref name="pmid27585063">{{cite journal| author=Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y| title=Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis (†). | journal=Ann Med | year= 2017 | volume= 49 | issue= 2 | pages= 106-116 | pmid=27585063 | doi=10.1080/07853890.2016.1231932 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27585063  }} </ref><ref name="pmid16731996">{{cite journal| author=Boyko EJ, Ahroni JH, Cohen V, Nelson KM, Heagerty PJ| title=Prediction of diabetic foot ulcer occurrence using commonly available clinical information: the Seattle Diabetic Foot Study. | journal=Diabetes Care | year= 2006 | volume= 29 | issue= 6 | pages= 1202-7 | pmid=16731996 | doi=10.2337/dc05-2031 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16731996  }} </ref>
*According to an other estimate the [[incidence]] of [[diabetic foot]] [[ulcer]] is approximately 1500 per 100,000 individuals worldwide.<ref name="pmid17280936">{{cite journal| author=Frykberg RG, Zgonis T, Armstrong DG, Driver VR, Giurini JM, Kravitz SR et al.| title=Diabetic foot disorders. A clinical practice guideline (2006 revision). | journal=J Foot Ankle Surg | year= 2006 | volume= 45 | issue= 5 Suppl | pages= S1-66 | pmid=17280936 | doi=10.1016/S1067-2516(07)60001-5 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17280936 }} </ref>
*The [[incidence]] of active [[diabetic foot]] [[ulcers]] in the US veterans is approximately 500 per 100,000 individuals.<ref name="pmid28614678">{{cite journal| author=Armstrong DG, Boulton AJM, Bus SA| title=Diabetic Foot Ulcers and Their Recurrence. | journal=N Engl J Med | year= 2017 | volume= 376 | issue= 24 | pages= 2367-2375 | pmid=28614678 | doi=10.1056/NEJMra1615439 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28614678  }} </ref><ref name="pmid12027925">{{cite journal| author=Abbott CA, Carrington AL, Ashe H, Bath S, Every LC, Griffiths J et al.| title=The North-West Diabetes Foot Care Study: incidence of, and risk factors for, new diabetic foot ulceration in a community-based patient cohort. | journal=Diabet Med | year= 2002 | volume= 19 | issue= 5 | pages= 377-84 | pmid=12027925 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12027925  }} </ref><ref name="pmid27585063">{{cite journal| author=Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y| title=Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis (†). | journal=Ann Med | year= 2017 | volume= 49 | issue= 2 | pages= 106-116 | pmid=27585063 | doi=10.1080/07853890.2016.1231932 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27585063  }} </ref><ref name="pmid16731996">{{cite journal| author=Boyko EJ, Ahroni JH, Cohen V, Nelson KM, Heagerty PJ| title=Prediction of diabetic foot ulcer occurrence using commonly available clinical information: the Seattle Diabetic Foot Study. | journal=Diabetes Care | year= 2006 | volume= 29 | issue= 6 | pages= 1202-7 | pmid=16731996 | doi=10.2337/dc05-2031 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16731996  }} </ref>
*The [[incidence]] of active [[diabetic foot]] [[ulcers]] in United Kingdom is approximately 220 per 100,000 individuals.<ref name="pmid28614678">{{cite journal| author=Armstrong DG, Boulton AJM, Bus SA| title=Diabetic Foot Ulcers and Their Recurrence. | journal=N Engl J Med | year= 2017 | volume= 376 | issue= 24 | pages= 2367-2375 | pmid=28614678 | doi=10.1056/NEJMra1615439 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28614678  }} </ref><ref name="pmid12027925">{{cite journal| author=Abbott CA, Carrington AL, Ashe H, Bath S, Every LC, Griffiths J et al.| title=The North-West Diabetes Foot Care Study: incidence of, and risk factors for, new diabetic foot ulceration in a community-based patient cohort. | journal=Diabet Med | year= 2002 | volume= 19 | issue= 5 | pages= 377-84 | pmid=12027925 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12027925  }} </ref>
*Based on another study, up to 25% of [[diabetes|diabetic]] [[patients]] develop [[diabetic foot]] within their [[disease]] period.<ref name="pmid24355275">{{cite journal| author=Alavi A, Sibbald RG, Mayer D, Goodman L, Botros M, Armstrong DG | display-authors=etal| title=Diabetic foot ulcers: Part I. Pathophysiology and prevention. | journal=J Am Acad Dermatol | year= 2014 | volume= 70 | issue= 1 | pages= 1.e1-18; quiz 19-20 | pmid=24355275 | doi=10.1016/j.jaad.2013.06.055 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24355275  }} </ref>
*It is estimated that 2% to 3% of [[diabetes|diabetic]] [[patients]] experience [[diabetic foot]] every year.<ref name="pmid25996397">{{cite journal| author=| title=Reorganized text. | journal=JAMA Otolaryngol Head Neck Surg | year= 2015 | volume= 141 | issue= 5 | pages= 428 | pmid=25996397 | doi=10.1001/jamaoto.2015.0540 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25996397  }} </ref><ref name="pmid2142042">{{cite journal| author=Borssén B, Bergenheim T, Lithner F| title=The epidemiology of foot lesions in diabetic patients aged 15-50 years. | journal=Diabet Med | year= 1990 | volume= 7 | issue= 5 | pages= 438-44 | pmid=2142042 | doi=10.1111/j.1464-5491.1990.tb01420.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2142042  }} </ref>
*Between 15 to 20 percent of [[diabetes|diabetic]] [[patients]] in the United States will be hospitalized due to [[diabetic foot]] and it's [[Complication (medicine)|complications]] at one point in their life.<ref name="pmid19445774">{{cite journal| author=Hunt D| title=Diabetes: foot ulcers and amputations. | journal=BMJ Clin Evid | year= 2009 | volume= 2009 | issue=  | pages=  | pmid=19445774 | doi= | pmc=2907821 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19445774  }} </ref>
 
===Prevalence===
*The [[prevalence]] of active [[diabetic foot]] [[ulcer|ulcers]] in United Kingdom is approximately 170 per 100,000 individuals.<ref name="pmid28614678">{{cite journal| author=Armstrong DG, Boulton AJM, Bus SA| title=Diabetic Foot Ulcers and Their Recurrence. | journal=N Engl J Med | year= 2017 | volume= 376 | issue= 24 | pages= 2367-2375 | pmid=28614678 | doi=10.1056/NEJMra1615439 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmo% de=ref&cmd=prlinks&id=28614678  }} </ref><ref name="pmid12027925">{{cite journal| author=Abbott CA, Carrington AL, Ashe H, Bath S, Every LC, Griffiths J et al.| title=The North-West Diabetes Foot Care Study: incidence of, and risk factors for, new diabetic foot ulceration in a community-based patient cohort. | journal=Diabet Med | year= 2002 | volume= 19 | issue= 5 | pages= 377-84 | pmid=12027925 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12027925  }} </ref>
*Based on a cohort study which studied 310 [[patients]] with [[diabetes|type 2 diabetes]], [[diabetic foot]] [[prevelance]] was found to be 18.1%.<ref name="pmid28936434">{{cite journal| author=Almobarak AO, Awadalla H, Osman M, Ahmed MH| title=Prevalence of diabetic foot ulceration and associated risk factors: an old and still major public health problem in Khartoum, Sudan? | journal=Ann Transl Med | year= 2017 | volume= 5 | issue= 17 | pages= 340 | pmid=28936434 | doi=10.21037/atm.2017.07.01 | pmc=5599292 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28936434  }} </ref>
*In a study done on a [[diabetes|diabetic]] population in Ethiopia, [[prevalence]] of [[diabetic foot]] [[ulcer]] has been estimated 13.6% with a 95% confidence interval (9.3-17.2) among 279 [[diabetes|diabetic]] [[patients]] who attend a [[diabetes|diabetic clinic]].<ref name="pmid28791310">{{cite journal| author=Mariam TG, Alemayehu A, Tesfaye E, Mequannt W, Temesgen K, Yetwale F | display-authors=etal| title=Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients Who Attend the Diabetic Follow-Up Clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-Based Cross-Sectional Study. | journal=J Diabetes Res | year= 2017 | volume= 2017 | issue=  | pages= 2879249 | pmid=28791310 | doi=10.1155/2017/2879249 | pmc=5534295 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28791310  }} </ref>
*[[Prevalence]] of [[diabetic foot]] have been reported 51.8% based on a community based [[cross-sectional study]] which evaluated 620 [[diabetes|diabetic]] [[patients]] in rural areas of India.<ref name="pmid29940924">{{cite journal| author=Vibha SP, Kulkarni MM, Kirthinath Ballala AB, Kamath A, Maiya GA| title=Community based study to assess the prevalence of diabetic foot syndrome and associated risk factors among people with diabetes mellitus. | journal=BMC Endocr Disord | year= 2018 | volume= 18 | issue= 1 | pages= 43 | pmid=29940924 | doi=10.1186/s12902-018-0270-2 | pmc=6020220 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29940924  }} </ref>
*The following table is a summary of [[prevalence]] of [[diabetic foot]] globally and in different regions:<ref name="pmid27585063">{{cite journal| author=Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y| title=Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis †. | journal=Ann Med | year= 2017 | volume= 49 | issue= 2 | pages= 106-116 | pmid=27585063 | doi=10.1080/07853890.2016.1231932 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27585063  }} </ref>
<br>
{| border="3"
! Region !! Prevalence of diabetic foot !! 95% Confidence interval
|-
! Global
| 6.3% || 5.4–7.3%
|-
! North America
|13.0%
|10.0–15.9%
|-
! Asia
|5.5%
|4.6–6.4%
|-
! Europe
|5.1%
|4.1–6.0%
|-
! Africa
|7.2%
|5.1–9.3%
|-
! Oceania
|3.0%
|0.9–5.0%
|}
<br>
 
===Mortality Rate===
*The 5 year risk of [[mortality rate|mortality]] in [[diabetes|diabetic]] [[patient|patients]] with a [[foot]] [[ulcer]] is 2.5 times higher than [[diabetes|diabetic individuals]] without a [[foot]] [[ulcer]].<ref name="pmid28614678">{{cite journal| author=Armstrong DG, Boulton AJM, Bus SA| title=Diabetic Foot Ulcers and Their Recurrence. | journal=N Engl J Med | year= 2017 | volume= 376 | issue= 24 | pages= 2367-2375 | pmid=28614678 | doi=10.1056/NEJMra1615439 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28614678  }} </ref>
*Based on 2 studies with different follow up duration, [[mortality rate]] of [[diabetic foot]] has been estimated as 10% and 24% in 16 months and 5 years follow up, respectively.<ref name="ChalletonLetanoux1993">{{cite journal|last1=Challeton|first1=JP|last2=Letanoux|first2=M|last3=Melki|first3=JP|last4=Mourad|first4=JJ|last5=Priollet|first5=P|title=Le pied diabétique: pronostic dans une série de 75 patients|journal=La Revue de Médecine Interne|volume=14|issue=10|year=1993|pages=1036|issn=02488663|doi=10.1016/S0248-8663(05)80153-5}}</ref><ref name="ChammasHill2016">{{cite journal|last1=Chammas|first1=N. K.|last2=Hill|first2=R. L. R.|last3=Edmonds|first3=M. E.|title=Increased Mortality in Diabetic Foot Ulcer Patients: The Significance of Ulcer Type|journal=Journal of Diabetes Research|volume=2016|year=2016|pages=1–7|issn=2314-6745|doi=10.1155/2016/2879809}}</ref>
*Another study done in Liverpool [[foot]] clinic reported 44% five year [[mortality rate|mortality]] in [[diabetes|diabetic]] [[patients]] with a new [[foot]] [[ulcer]].<ref name="MoulikMtonga2003">{{cite journal|last1=Moulik|first1=P. K.|last2=Mtonga|first2=R.|last3=Gill|first3=G. V.|title=Amputation and Mortality in New-Onset Diabetic Foot Ulcers Stratified by Etiology|journal=Diabetes Care|volume=26|issue=2|year=2003|pages=491–494|issn=0149-5992|doi=10.2337/diacare.26.2.491}}</ref>
*Based on a study done in Spain [[mortality rate|mortality]] has been reported 28 among 1000 [[patients]] per year and the main cause (31.2%) was cardiovascular [[disease]].<ref name="pmid18779037">{{cite journal| author=Mundet X, Pou A, Piquer N, Sanmartin MI, Tarruella M, Gimbert R | display-authors=etal| title=Prevalence and incidence of chronic complications and mortality in a cohort of type 2 diabetic patients in Spain. | journal=Prim Care Diabetes | year= 2008 | volume= 2 | issue= 3 | pages= 135-40 | pmid=18779037 | doi=10.1016/j.pcd.2008.05.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18779037  }} </ref> Another study done in England demonstrated the cardiovascular [[disease]]s as the main cause of death in [[diabetic foot]] [[patients]] as well.<ref name="ChammasHill2016">{{cite journal|last1=Chammas|first1=N. K.|last2=Hill|first2=R. L. R.|last3=Edmonds|first3=M. E.|title=Increased Mortality in Diabetic Foot Ulcer Patients: The Significance of Ulcer Type|journal=Journal of Diabetes Research|volume=2016|year=2016|pages=1–7|issn=2314-6745|doi=10.1155/2016/2879809}}</ref>
 
===Age===
Based on a [[systematic review]] and [[Meta-analysis|metanalysis]] done on [[diabetes]] [[patients]], [[diabetic foot]] was more common among older [[patients]].<ref name="pmid27585063">{{cite journal| author=Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y| title=Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis †. | journal=Ann Med | year= 2017 | volume= 49 | issue= 2 | pages= 106-116 | pmid=27585063 | doi=10.1080/07853890.2016.1231932 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27585063  }} </ref><ref name="pmid25685277">{{cite journal| author=Yazdanpanah L, Nasiri M, Adarvishi S| title=Literature review on the management of diabetic foot ulcer. | journal=World J Diabetes | year= 2015 | volume= 6 | issue= 1 | pages= 37-53 | pmid=25685277 | doi=10.4239/wjd.v6.i1.37 | pmc=4317316 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25685277  }} </ref>
 
===Race===
White people develop [[diabetes|diabetic]] [[peripheral neuropathy]] (which is a serious [[risk factor]] for [[diabetic foot]]) more frequently.<ref name="pmid21750334">{{cite journal| author=Wang W, Balamurugan A, Biddle J, Rollins KM| title=Diabetic neuropathy status and the concerns in underserved rural communities: challenges and opportunities for diabetes educators. | journal=Diabetes Educ | year= 2011 | volume= 37 | issue= 4 | pages= 536-48 | pmid=21750334 | doi=10.1177/0145721711410717 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21750334 }} </ref>


===Gender===
===Gender===
In 1987, Borch-Johnsen et al. described a male preponderance for the development of severe microvascular complications <ref name="pmid2956021">{{cite journal| author=Borch-Johnsen K, Nissen H, Salling N, Henriksen E, Kreiner S, Deckert T et al.| title=The natural history of insulin-dependent diabetes in Denmark: 2. Long-term survival--who and why. | journal=Diabet Med | year= 1987 | volume= 4 | issue= 3 | pages= 211-6 | pmid=2956021 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2956021  }} </ref>. Diabetic foot disease is not an exception to this rule. For unknown reasons , men have a higher risk of diabetic foot disease compared to women. Some possible explanations are a higher bioavailability of [[nitric oxide]] (NO) bioavailability and NO responsiveness and the protective role of [[estrogen]] in women <ref name="pmid12538427">{{cite journal| author=Gladwin MT, Schechter AN, Ognibene FP, Coles WA, Reiter CD, Schenke WH et al.| title=Divergent nitric oxide bioavailability in men and women with sickle cell disease. | journal=Circulation | year= 2003 | volume= 107 | issue= 2 | pages= 271-8 | pmid=12538427 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12538427  }} </ref>. However the beneficial effect of these factors are reversed by [[diabetes]], irrespective of menopausal status.Nevertheless men still have a higher risk for having diabetic foot disease .
*In 1987, Borch-Johnsen et al. described a [[male]] preponderance for the development of severe [[Microvascular disease|microvascular]] [[Complication (medicine)|complications]] and [[diabetic foot]] [[disease]] is not an exception to this rule.<ref name="pmid2956021">{{cite journal| author=Borch-Johnsen K, Nissen H, Salling N, Henriksen E, Kreiner S, Deckert T et al.| title=The natural history of insulin-dependent diabetes in Denmark: 2. Long-term survival--who and why. | journal=Diabet Med | year= 1987 | volume= 4 | issue= 3 | pages= 211-6 | pmid=2956021 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2956021  }} </ref> <ref name="pmid9448554">{{cite journal| author=Lavery LA, Armstrong DG, Vela SA, Quebedeaux TL, Fleischli JG| title=Practical criteria for screening patients at high risk for diabetic foot ulceration. | journal=Arch Intern Med | year= 1998 | volume= 158 | issue= 2 | pages= 157-62 | pmid=9448554 | doi=10.1001/archinte.158.2.157 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9448554  }} </ref>
*For unknown reasons, [[male|men]] have a higher risk of [[diabetic foot]] [[disease]] compared to [[female|women]].<ref name="pmid25685277">{{cite journal| author=Yazdanpanah L, Nasiri M, Adarvishi S| title=Literature review on the management of diabetic foot ulcer. | journal=World J Diabetes | year= 2015 | volume= 6 | issue= 1 | pages= 37-53 | pmid=25685277 | doi=10.4239/wjd.v6.i1.37 | pmc=4317316 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25685277  }} </ref><ref name="pmid25543864">{{cite journal| author=Assaad-Khalil SH, Zaki A, Abdel Rehim A, Megallaa MH, Gaber N, Gamal H | display-authors=etal| title=Prevalence of diabetic foot disorders and related risk factors among Egyptian subjects with diabetes. | journal=Prim Care Diabetes | year= 2015 | volume= 9 | issue= 4 | pages= 297-303 | pmid=25543864 | doi=10.1016/j.pcd.2014.10.010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25543864  }} </ref>
*Few possible explanations could be the higher [[bioavailability]] of [[nitric oxide]] ([[nitric oxide|NO]]), higher responsiveness to [[nitric oxide|NO]] and the protective role of [[estrogen]] in [[females|women]]. <ref name="pmid12538427">{{cite journal| author=Gladwin MT, Schechter AN, Ognibene FP, Coles WA, Reiter CD, Schenke WH et al.| title=Divergent nitric oxide bioavailability in men and women with sickle cell disease. | journal=Circulation | year= 2003 | volume= 107 | issue= 2 | pages= 271-8 | pmid=12538427 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12538427  }} </ref>. However the beneficial effect of these factors could be reversed by [[diabetes]] itself and irrespective of the [[Menopause|menopausal status]] of [[female]] [[patients]].
 
===Region===
*Highest [[prevelance]] of [[diabetic foot]] has been reported in North America.<ref name="pmid27585063">{{cite journal| author=Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y| title=Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis †. | journal=Ann Med | year= 2017 | volume= 49 | issue= 2 | pages= 106-116 | pmid=27585063 | doi=10.1080/07853890.2016.1231932 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27585063  }} </ref>
*Lowest [[prevalence]] of [[diabetic foot]] has been reported in Oceania. 
*Africa has higher [[prevalence]] of [[diabetic foot]], compared to Asia and Europe.


==References==
==References==
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Latest revision as of 19:28, 17 September 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2] Vishnu Vardhan Serla M.B.B.S. [3] Usama Talib, BSc, MD [4]

Overview

The incidence of diabetic foot ulcer is approximately 1500 per 100,000 diabetic individuals world wide. Among the US veterans the incidence of active diabetic foot ulcers is approximately 500 per 100,000 individuals. On the other hand the incidence of active diabetic foot ulcers in United Kingdom has been estimated 220 per 100,000 individuals. Furthermore it's prevalence has been reported 170 per 100,000 individuals among the United Kingdom population. The 5 year risk of mortality in diabetic patients with a foot ulcer is 2.5 times higher than diabetic individuals without a foot ulcer. Based on 2 studies with different follow up duration, mortality rate of diabetic foot has been estimated as 10% and 24% in 16 months and 5 years follow up, respectively. Based on a systematic review and metanalysis done on diabetes patients, diabetic foot was more common among older patients. White people develop diabetic peripheral neuropathy (which is a serious risk factor for diabetic foot) more frequently. In 1987, Borch-Johnsen et al. described a male preponderance for the development of severe microvascular complications and diabetic foot disease is not an exception to this rule. Highest prevelance of diabetic foot has been reported in North America. In contrast, Oceania has the lowest reported prevelance of diabetic foot.

Epidemiology and Demographics

Incidence

Prevalence


Region Prevalence of diabetic foot 95% Confidence interval
Global 6.3% 5.4–7.3%
North America 13.0% 10.0–15.9%
Asia 5.5% 4.6–6.4%
Europe 5.1% 4.1–6.0%
Africa 7.2% 5.1–9.3%
Oceania 3.0% 0.9–5.0%


Mortality Rate

Age

Based on a systematic review and metanalysis done on diabetes patients, diabetic foot was more common among older patients.[3][17]

Race

White people develop diabetic peripheral neuropathy (which is a serious risk factor for diabetic foot) more frequently.[18]

Gender

Region

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Armstrong DG, Boulton AJM, Bus SA (2017). "Diabetic Foot Ulcers and Their Recurrence". N Engl J Med. 376 (24): 2367–2375. doi:10.1056/NEJMra1615439. PMID 28614678.
  2. ↑ 2.0 2.1 2.2 2.3 Abbott CA, Carrington AL, Ashe H, Bath S, Every LC, Griffiths J; et al. (2002). "The North-West Diabetes Foot Care Study: incidence of, and risk factors for, new diabetic foot ulceration in a community-based patient cohort". Diabet Med. 19 (5): 377–84. PMID 12027925.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y (2017). "Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis (†)". Ann Med. 49 (2): 106–116. doi:10.1080/07853890.2016.1231932. PMID 27585063.
  4. ↑ 4.0 4.1 Boyko EJ, Ahroni JH, Cohen V, Nelson KM, Heagerty PJ (2006). "Prediction of diabetic foot ulcer occurrence using commonly available clinical information: the Seattle Diabetic Foot Study". Diabetes Care. 29 (6): 1202–7. doi:10.2337/dc05-2031. PMID 16731996.
  5. ↑ Frykberg RG, Zgonis T, Armstrong DG, Driver VR, Giurini JM, Kravitz SR; et al. (2006). "Diabetic foot disorders. A clinical practice guideline (2006 revision)". J Foot Ankle Surg. 45 (5 Suppl): S1–66. doi:10.1016/S1067-2516(07)60001-5. PMID 17280936.
  6. ↑ Alavi A, Sibbald RG, Mayer D, Goodman L, Botros M, Armstrong DG; et al. (2014). "Diabetic foot ulcers: Part I. Pathophysiology and prevention". J Am Acad Dermatol. 70 (1): 1.e1–18, quiz 19-20. doi:10.1016/j.jaad.2013.06.055. PMID 24355275.
  7. ↑ "Reorganized text". JAMA Otolaryngol Head Neck Surg. 141 (5): 428. 2015. doi:10.1001/jamaoto.2015.0540. PMID 25996397.
  8. ↑ Borssén B, Bergenheim T, Lithner F (1990). "The epidemiology of foot lesions in diabetic patients aged 15-50 years". Diabet Med. 7 (5): 438–44. doi:10.1111/j.1464-5491.1990.tb01420.x. PMID 2142042.
  9. ↑ Hunt D (2009). "Diabetes: foot ulcers and amputations". BMJ Clin Evid. 2009. PMC 2907821. PMID 19445774.
  10. ↑ Almobarak AO, Awadalla H, Osman M, Ahmed MH (2017). "Prevalence of diabetic foot ulceration and associated risk factors: an old and still major public health problem in Khartoum, Sudan?". Ann Transl Med. 5 (17): 340. doi:10.21037/atm.2017.07.01. PMC 5599292. PMID 28936434.
  11. ↑ Mariam TG, Alemayehu A, Tesfaye E, Mequannt W, Temesgen K, Yetwale F; et al. (2017). "Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients Who Attend the Diabetic Follow-Up Clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-Based Cross-Sectional Study". J Diabetes Res. 2017: 2879249. doi:10.1155/2017/2879249. PMC 5534295. PMID 28791310.
  12. ↑ Vibha SP, Kulkarni MM, Kirthinath Ballala AB, Kamath A, Maiya GA (2018). "Community based study to assess the prevalence of diabetic foot syndrome and associated risk factors among people with diabetes mellitus". BMC Endocr Disord. 18 (1): 43. doi:10.1186/s12902-018-0270-2. PMC 6020220. PMID 29940924.
  13. ↑ Challeton, JP; Letanoux, M; Melki, JP; Mourad, JJ; Priollet, P (1993). "Le pied diabétique: pronostic dans une série de 75 patients". La Revue de Médecine Interne. 14 (10): 1036. doi:10.1016/S0248-8663(05)80153-5. ISSN 0248-8663.
  14. ↑ 14.0 14.1 Chammas, N. K.; Hill, R. L. R.; Edmonds, M. E. (2016). "Increased Mortality in Diabetic Foot Ulcer Patients: The Significance of Ulcer Type". Journal of Diabetes Research. 2016: 1–7. doi:10.1155/2016/2879809. ISSN 2314-6745.
  15. ↑ Moulik, P. K.; Mtonga, R.; Gill, G. V. (2003). "Amputation and Mortality in New-Onset Diabetic Foot Ulcers Stratified by Etiology". Diabetes Care. 26 (2): 491–494. doi:10.2337/diacare.26.2.491. ISSN 0149-5992.
  16. ↑ Mundet X, Pou A, Piquer N, Sanmartin MI, Tarruella M, Gimbert R; et al. (2008). "Prevalence and incidence of chronic complications and mortality in a cohort of type 2 diabetic patients in Spain". Prim Care Diabetes. 2 (3): 135–40. doi:10.1016/j.pcd.2008.05.001. PMID 18779037.
  17. ↑ 17.0 17.1 Yazdanpanah L, Nasiri M, Adarvishi S (2015). "Literature review on the management of diabetic foot ulcer". World J Diabetes. 6 (1): 37–53. doi:10.4239/wjd.v6.i1.37. PMC 4317316. PMID 25685277.
  18. ↑ Wang W, Balamurugan A, Biddle J, Rollins KM (2011). "Diabetic neuropathy status and the concerns in underserved rural communities: challenges and opportunities for diabetes educators". Diabetes Educ. 37 (4): 536–48. doi:10.1177/0145721711410717. PMID 21750334.
  19. ↑ Borch-Johnsen K, Nissen H, Salling N, Henriksen E, Kreiner S, Deckert T; et al. (1987). "The natural history of insulin-dependent diabetes in Denmark: 2. Long-term survival--who and why". Diabet Med. 4 (3): 211–6. PMID 2956021.
  20. ↑ Lavery LA, Armstrong DG, Vela SA, Quebedeaux TL, Fleischli JG (1998). "Practical criteria for screening patients at high risk for diabetic foot ulceration". Arch Intern Med. 158 (2): 157–62. doi:10.1001/archinte.158.2.157. PMID 9448554.
  21. ↑ Assaad-Khalil SH, Zaki A, Abdel Rehim A, Megallaa MH, Gaber N, Gamal H; et al. (2015). "Prevalence of diabetic foot disorders and related risk factors among Egyptian subjects with diabetes". Prim Care Diabetes. 9 (4): 297–303. doi:10.1016/j.pcd.2014.10.010. PMID 25543864.
  22. ↑ Gladwin MT, Schechter AN, Ognibene FP, Coles WA, Reiter CD, Schenke WH; et al. (2003). "Divergent nitric oxide bioavailability in men and women with sickle cell disease". Circulation. 107 (2): 271–8. PMID 12538427.
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