55,806
Views
800
CrossRef citations to date
0
Altmetric
Review Article

Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis

, , , , &
Pages 106-116 | Received 22 May 2016, Accepted 30 Aug 2016, Published online: 03 Nov 2016

References

  • Apelqvist J. Diagnostics and treatment of the diabetic foot. Endocrine. 2012;41:384–97.
  • Boulton AJ, Vileikyte L, Ragnarson-Tennvall G, Apelqvist J. The global burden of diabetic foot disease. Lancet. 2005;366:1719–24.
  • Tennvall GR, Apelqvist J. Health-economic consequences of diabetic foot lesions. Clin Infect Dis. 2004;39(Suppl 2): S132–9.
  • Rice JB, Desai U, Cummings AK, Birnbaum HG, Skornicki M, Parsons NB. Burden of diabetic foot ulcers for medicare and private insurers. Diabetes Care. 2014;37:651–8.
  • Jeffcoate W, Bakker K. World diabetes day: footing the bill. Lancet. 2005;365:1527.
  • Lepäntalo M, Apelqvist J, Setacci C, Ricco JB, de Donato G, Becker F, et al. Chapter V: diabetic foot. Eur J Vasc Endovasc. 2011;42:S60–74.
  • Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Prev Med. 2007;45:247–51.
  • Higgins JPT, Thompson SG, Deeks JJ. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–60.
  • El-Nahas M, Gawish H, Tarshoby M, State O, Boulton A. The prevalence of risk factors for foot ulceration in Egyptian diabetic patients. Pract Diabetes Int. 2008;25:362–6.
  • Rerkasem K. Seminar review: sociocultural practices and epidemiology of diabetic foot problem: lessons from a study in Chiang Mai University Hospital, Thailand. Int J Low Extrem Wounds. 2011;10:86–90.
  • Ndip EA, Tchakonte B, Mbanya JC. A study of the prevalence and risk factors of foot problems in a population of diabetic patients in Cameroon. Int J Low Extrem Wounds. 2006;5:83–8.
  • Riaz M, Miyan Z, Zaidi SI, Alvi SF, Fawwad A, Ahmadani MY, et al. Characteristics of a large cohort of patients with diabetes having at-risk feet and outcomes in patients with foot ulceration referred to a tertiary care diabetes unit. Int Wound J. 2016;13:594–99.
  • Tseng C-H. Prevalence and risk factors of diabetic foot problems in Taiwan. Diabetes Care. 2003;26:3351. doi:10.2337/diacare.26.12.3351.
  • Khuwaja AK, Rafique G, White F, Azam SI. Macrovascular complications and their associated factors among persons with type 2 diabetes in Karachi, Pakistan – a multi-center study. J Pak Med Assoc. 2004;54:60–6.
  • Reenders K, De Nobel E, Van den Hoogen HJ, Rutten GE, van Weel C. Diabetes and its long-term complications in general practice: a survey in a well-defined population. Fam Practice. 1993;10:169–72.
  • Al-Rubeaan K, Al Derwish M, Ouizi S, Youseef AM, Subhani SN, Ibrahim HM, et al. Diabetic foot complications and their risk factors from a large retrospective cohort study. PLoS One. 2015;10:e0124446. doi: 10.1371/journal.pone.0124446.
  • Bakri F, Allan A, Khader Y, Younes NA, Ajlouni KM. Prevalence of diabetic foot ulcer and its associated risk factors among diabetic patients in Jordan. J Med J. 2012;46:118–25.
  • Gulliford MC, Mahabir D. Diabetic foot disease and foot care in a Caribbean Community. Diabetes Res Clin Pract. 2002;56:35–40.
  • Iversen MM, Midthjell K, Østbye T, Tell GS, Clipp E, Sloane R, et al. History of and factors associated with diabetic foot ulcers in Norway: the Nord-Trøndelag Health Study. Scand J Public Health. 2008;36:62–8.
  • Won JC, Kwon HS, Kim CH, Lee JH, Park TS, Ko KS, et al. Prevalence and clinical characteristics of diabetic peripheral neuropathy in hospital patients with Type 2 diabetes in Korea. Diabet Med. 2012;29:e290–6.
  • Win Tin ST, Kenilorea G, Gadabu E, Tasserei J, Colagiuri R. The prevalence of diabetes complications and associated risk factors in Pacific Islands countries. Diabetes Res Clin Pract. 2014;103:114–18.
  • Tapp RJ, Shaw JE, De Courten MP, Dunstan DW, Welborn TA, Zimmet PZ, et al. Foot complications in Type 2 diabetes: an Australian population-based study. Diabet Med. 2003;20:105–13.
  • De Sonnaville JJ, Colly LP, Wijkel D, Heine RJ. The prevalence and determinants of foot ulceration in type II diabetic patients in a primary health care setting. Diabetes Res Clin Pract. 1997;35:149–56.
  • Cabezas-Cerrato J. The prevalence of clinical diabetic polyneuropathy in Spain: a study in primary care and hospital clinic groups. Neuropathy Spanish Study Group of the Spanish Diabetes Society (SDS). Diabetologia. 1998;41:1263–9.
  • Liu ZL, Fu CW, Wang WB, Xu B. Prevalence of chronic complications of type 2 diabetes mellitus in outpatients – a cross-sectional hospital based survey in urban China. Health Qual Life Outcomes. 2010;8:62. doi: 10.1186/1477-7525-8-62.
  • Al-Mahroos F, Al-Roomi K. Diabetic neuropathy, foot ulceration, peripheral vascular disease and potential risk factors among patients with diabetes in Bahrain: a nationwide primary care diabetes clinic-based study. Ann Saudi Med. 2007;27:25–31.
  • Alonso-Morán E, Orueta JF, Fraile Esteban JI, Axpe JMA, González MLM, Polanco NT, et al. The prevalence of diabetes-related complications and multimorbidity in the population with type 2 diabetes mellitus in the Basque Country. BMC Public Health. 2014;14:1059. doi: 10.1186/1471-2458-14-1059.
  • Bała MM, Płaczkiewicz-Jankowska E, Topór-Madry R, et al. Characteristics of patients with type 2 diabetes of short duration in Poland: rationale, design and preliminary results of the ARETAEUS1 study. Pol Arch Med Wewn. 2009;119:533–40.
  • Gall M-A, Rossing P, Skøtt P, Damsbo P, Vaag A, Bech K, et al. Prevalence of micro- and macroalbuminuria, arterial hypertension, retinopathy and large vessel disease in European type 2 (non-insulin-dependent) diabetic patients. Diabetologia. 1991;34:655–61.
  • Kiani J, Moghimbeigi A, Azizkhani H, Kosarifard S. The prevalence and associated risk factors of peripheral diabetic neuropathy in Hamedan, Iran. Arch Iran Med. 2013;16:17–19.
  • Manes C, Papazoglou N, Sossidou E, Soulis K, Milarakis D, Satsoglou A, et al. Prevalence of diabetic neuropathy and foot ulceration: identification of potential risk factors – a population-based study. Woundsa Compend Clin Res Pract. 2002;14:11–15.
  • Tariq C, Afzal W. Long-term complications of diabetes and co-morbidities contributing to atherosclerosis in diabetic population of Mirpur, Azad Kashmir. J Pak Med Assoc. 2013;63:1383–6.
  • Ji LN, Lu JM, Guo XH, Yang WY, Weng JP, Jia WP, et al. Glycemic control among patients in China with type 2 diabetes mellitus receiving oral drugs or injectables. BMC Public Health. 2013;13:602. doi: 10.1186/1471-2458-13-602.
  • Bi Y, Zhu D, Cheng J, Zhu Y, Xu N, Cui S, et al. The status of glycemic control: a cross-sectional study of outpatients with type 2 diabetes mellitus across primary, secondary, and tertiary hospitals in the Jiangsu Province of China. Clin Ther. 2010;32:973–83.
  • Kim SS, Won JC, Kwon HS, Kim CH, Lee JH, Park TS, et al. Prevalence and clinical implications of painful diabetic peripheral neuropathy in type 2 diabetes: results from a nationwide hospital-based study of diabetic neuropathy in Korea. Diabetes Res Clin Pract. 2014;103:522–9.
  • Aubert CE, Michel PL, Gillery P, Jaisson S, Fonfrede M, Morel F, et al. Association of peripheral neuropathy with circulating advanced glycation end products, soluble receptor for advanced glycation end products and other risk factors in patients with type 2 diabetes. Diabetes Metab Res Rev. 2014;30:679–85.
  • Reid KS, Martin BD, Duerksen F, Nicolle LE, Garrett M, Simonsen JN, et al. Diabetic foot complications in a northern Canadian aboriginal community. Foot Ankle Int. 2006;27:1065–73.
  • Sämann A, Tajiyeva O, Müller N, Tschauner T, Hoyer H, Wolf G, et al. Prevalence of the diabetic foot syndrome at the primary care level in Germany: a cross-sectional study. Diabet Med. 2008;25:557–63.
  • Huang IC, Liu JH, Wu AW, Wu MY, Leite W, Hwang CC. Evaluating the reliability, validity and minimally important difference of the Taiwanese version of the diabetes quality of life (DQOL) measurement. Health Qual Life Outcomes. 2008;6:87. doi: 10.1186/1477-7525-6-87.
  • Hu H, Han CM, Hu XL, Ye WL, Huang WJ, Smit AJ. Elevated skin autofluorescence is strongly associated with foot ulcers in patients with diabetes: a cross-sectional, observational study of Chinese subjects. J Zhejiang Univ Sci B. 2012;13:372–7.
  • Yu X, Song S, Yang F, Dai H, Yang Z. Clinical features of diabetes retinopathy in elderly patients with type 2 diabetes in Northern Chinese. Niger J Clin Pract. 2015;18:183–8.
  • Coll-de-Tuero G, Mata-Cases M, Rodriguez-Poncelas A, Pepió JM, Roura P, Benito B, et al. Chronic kidney disease in the type 2 diabetic patients: prevalence and associated variables in a random sample of 2642 patients of a Mediterranean area. BMC Nephrol. 2012;13:1.
  • Masson EA, MacFarlane IA, Power E, Wallymahmed M. An audit of the management and outcome of hospital inpatients with diabetes: resource planning implications for the diabetes care team. Diabet Med. 1992;9:753–5.
  • Potisat S, Krairittichai U, Jongsareejit A, Sattaputh C, Arunratanachote W. A 4-year prospective study on long-term complications of type 2 diabetic patients: the Thai DMS diabetes complications (DD. Comp.) project. J Med Assoc Thai. 2013;96:637–43.
  • Shahi SK, Kumar A, Kumar S, Singh SK. Prevalence of diabetic foot ulcer and associated risk factors in diabetic patients from North India. J Diabetic Foot Compl. 2012;4:83–91.
  • Davis WA, Norman PE, Bruce DG, Davis TM. Predictors, consequences and costs of diabetes-related lower extremity amputation complicating type 2 diabetes: the Fremantle Diabetes Study. Diabetologia. 2006;49:2634–41.
  • Alavi A, Sanjari M, Haghdoost A, Sibbald RG. Common foot examination features of 247 Iranian patients with diabetes. Int Wound J. 2009;6:117–22.
  • Demirseren DD, Emre S, Akoglu G, Arpacı D, Arman A, Metin A, et al. Relationship between skin diseases and extracutaneous complications of diabetes mellitus: clinical analysis of 750 patients. Am J Clin Dermatol. 2014;15:65–70.
  • Acquati S, Gagliardi L, Taroni S, Tartaglia A, Buci L, Manini F, et al. Diabetic foot screening: an observational study in a population of diabetics in Forli' (Northern Italy). 2010 EASD Astract, Presentation number 1151.
  • Adler AI, Boyko EJ, Ahroni JH, Smith DG. Lower-extremity amputation in diabetes. The independent effects of peripheral vascular disease, sensory neuropathy, and foot ulcers. Diabetes Care. 1999;22:1029–35.
  • Helmer D, Tseng CL, Wrobel J, Tiwari A, Rajan M, Pogach L, et al. Assessing the risk of lower extremity amputations using an administrative data-based foot risk index in elderly patients with diabetes. J Diabetes. 2011;3:248–55.
  • Mundet X, Cano F, Mata-Cases M, Roura P, Franch J, Birules M, et al. Trends in chronic complications of type 2 diabetic patients from Spanish primary health care centres (GEDAPS study): ten year-implementation of St. Vincent recommendations. Prim Care Diabetes. 2012;6:11–18.
  • Mundet X, Pou A, Piquer N, Sanmartin M, Tarruella M, Gimbert R, et al. Prevalence and incidence of chronic complications and mortality in a cohort of type 2 diabetic patients in Spain. Prim Care Diabetes. 2008;2:135–40.
  • Hurley L, Kelly L, Garrow AP, Glynn L, McIntosh C, Alvarez-Iglesias A, et al. A prospective study of risk factors for foot ulceration: the West of Ireland Diabetes Foot Study. QJM. 2013;106:1103–10.
  • Jayaprakash P, Bhansali S, Bhansali A, Dutta P, Anantharaman R. Magnitude of foot problems in diabetes in the developing world: a study of 1044 patients. Diabet Med. 2009;26:939–42.
  • Riffi A, Devroey D, Van De Vijver E. A comparison between Moroccan and Belgian type-2 diabetic patients. Acta Clin Belg. 2012;67:246–9.
  • Kengne AP, Djouogo CF, Dehayem MY, Fezeu L, Sobngwi E, Lekoubou A, et al. Admission trends over 8 years for diabetic foot ulceration in a specialized diabetes unit in cameroon. Int J Low Extrem Wounds. 2009;8:180–6.
  • Levitt NS, Bradshaw D, Zwarenstein MF, Bawa AA, Maphumolo S. Audit of public sector primary diabetes care in Cape Town, South Africa: high prevalence of complications, uncontrolled hyperglycaemia, and hypertension. Diabet Med. 1997;14:1073–7.
  • Ye X, Cao Y, Gao F, et al. Elevated serum uric acid levels are independent risk factors for diabetic foot ulcer in female Chinese patients with type 2 diabetes. J Diabetes. 2014;6:42–7.
  • Wu LF, Hou Q, Zhou QH, Peng F. Prevalence of risk factors for diabetic foot complications in a Chinese tertiary hospital. Int J Clin Exp Med. 2015;8:3785–92.
  • Kengne AP, Choukem SP, Dehayem YM, Simo NL, Fezeu LL, Mbanya JC. Diabetic foot ulcers in Cameroon: can microflora prevalence inform probabilistic antibiotic treatment? J Wound Care. 2006;15:363–6.
  • Neuhann HF, Warter-Neuhann C, Lyaruu I, Msuya L. Diabetes care in Kilimanjaro region: clinical presentation and problems of patients of the diabetes clinic at the regional referral hospital-an inventory before structured intervention. Diabet Med. 2002;19:509–13.
  • Jbour AKS, Jarrah NS, Radaideh ARM, Shegem NS, Bader IM, Batieha AM, et al. Prevalence and predictors of diabetic foot syndrome in type 2 diabetes mellitus in Jordan. Saudi Med J. 2003;24:761–4.
  • Wikblad K, Smide B, Bergström A, Kessi J, Mugusi F. Outcome of clinical foot examination in relation to self-perceived health and glycaemic control in a group of urban Tanzanian diabetic patients. Diabetes Res Clin Pract. 1997;37:185–92.
  • Nambuya AP, Otim MA, Whitehead H. The presentation of newly-diagnosed diabetic patients in Uganda. QJM. 1996;89:705–11.
  • Lavery LA, Armstrong DG, Wunderlich RP, Tredwell J, Boulton AJ. Diabetic foot syndrome: evaluating the prevalence and incidence of foot pathology in Mexican Americans and non-Hispanic whites from a diabetes disease management cohort. Diabetes Care. 2003;26:1435–8.
  • Kumar S, Ashe HA, Parnell LN, Fernando DJS, Tsigos C, Young RJ, et al. The prevalence of foot ulceration and its correlates in type 2 diabetic patients: a population-based study. Diabet Med. 1994;11:480–4.
  • Li H, Chen BK, Shah N, Wang Z, Eggleston KN. Socioeconomic correlates of inpatient spending for patients with type 2 diabetes mellitus in China: evidence from Hangzhou. Exp Clin Endocrinol Diabetes. 2012;120:35–44.
  • Shera AS, Jawad F, Maqsood A, Jamal S, Azfar M, Ahmed U. Prevalence of chronic complications and associated factors in type 2 diabetes. J Pak Med Assoc. 2004;54:54–9.
  • Abbott CA, Garrow AP, Carrington AL, Morris J, Van Ross ER, Boulton AJ, et al. Foot ulcer risk is lower in South-Asian and African-Caribbean compared with European diabetic patients in the U.K.: the North-West diabetes foot care study. Diabetes Care. 2005;28:1869–75.
  • Walters DP, Gatling W, Mullee MA, Hill RD. The distribution and severity of diabetic foot disease: a community study with comparison to a non-diabetic group. Diabet Med. 1992;9:354–8.
  • Rotchford A, Rotchford K. Diabetes in rural South Africa – an assessment of care and complications. S Afr Med J. 2002;92:536–41.
  • Kuzuya T, Akanuma Y, Akazawa Y, Uehata T. Prevalence of chronic complications in Japanese diabetic patients. Diabetes Res Clin Pract. 1994;24(Suppl): S159–64.
  • Müller UA, Ross IS, Klinger H, Geisenheiner S, Chantelau EA. Quality of centralized diabetes care: a population-based study in the German Democratic Republic 1989-1990. Acta Diabetol. 1993;30:166–72.
  • El-Sewy FZ, Abou-Zeid AA, Helmy TA, Abou-Alkhair AF, El Baz SS. Screening of acute and chronic diabetic complications among A cohort of diabetic patients admitted to intensive care unit. Life Sci J – Acta Zhengzhou Univ Overseas Ed. 2011;8:719–32.
  • Van Acker K, Oleen-Burkey M, De Decker L, Vanmaele R, Van Schil P, Matricali G, et al. Cost and resource utilization for prevention and treatment of foot lesions in a diabetic foot clinic in Belgium. Diabetes Res Clin Pract. 2000;50:87–95.
  • Centers for Disease Control and Prevention. Cigarette smoking among adults – United States 2006. Morb Mortal Wkly Rep. 2007;56:1157–61.
  • Jensen JA, Goodson WH, Hopf HW, Hunt TK. Cigarette smoking decreases tissue oxygen. Arch Surg. 1991;126:1131–4.
  • Obaid H, Eljedi A. Risk factors for the development of diabetic foot ulcers in Gaza Strip: a case–control study. Int J Diabetes Res. 2015;4:1–6.
  • Hublet A, De Bacquer D, Valimaa R, Godeau E, Schmid H, Rahav G, et al. Smoking trends among adolescents from 1990 to 2002 in ten European countries and Canada. BMC Public Health. 2006;6:1.
  • Tapp RJ, Zimmet PZ, Harper CA, De Courten MP, Balkau B, McCarty DJ, et al. Diabetes care in an Australian population frequency of screening examinations for eye and foot complications of diabetes. Diabetes Care. 2004;27:688–93.
  • Colman GP, Beischer AD. Lower-limb amputation and diabetes: the key is prevention. Med J Aust. 2000;173: 341–2.
  • Boyko EJ, Ahroni JH, Cohen V, Nelson KM, Heagerty PJ. Prediction of diabetic foot ulcer occurrence using commonly available clinical information the Seattle Diabetic Foot Study. Diabetes Care. 2006;29:1202–7.
  • Pham H, Armstrong DG, Harvey C, Harkless LB, Giurini JM, Veves A. Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial. Diabetes Care. 2000;23:606–11.
  • Merza Z, Tesfaye S. The risk factors for diabetic foot ulceration. Foot. 2003;13:125–9.
  • Boyko EJ, Ahroni JH, Stensel V, Forsberg RC, Davignon DR, Smith DG. A prospective study of risk factors for diabetic foot ulcer. The Seattle Diabetic Foot Study. Diabetes Care. 1999;22:1036–42.
  • Sohn MW, Budiman-Mak E, Lee TA, Oh E, Stuck RM. Significant J-shaped association between body mass index (BMI) and diabetic foot ulcers. Diabetes Metab Res Rev. 2011;27:402–9.
  • Schramm JC, Dinh T, Veves A. Microvascular changes in the diabetic foot. Int J Low Extrem Wounds. 2006;5:149–59.
  • Mohora M, Vîrgolici B, Coman A, Muscurel C, Găman L, Gruia V. Diabetic foot patients with and without retinopathy and plasma oxidative stress. Rom J Intern Med. 2007;45:51–7.
  • Dehghan A, Van Hoek M, Sijbrands EJ, Hofman A, Witteman JC. High serum uric acid as a novel risk factor for type 2 diabetes. Diabetes Care. 2008;31:361–2.
  • Kim CH, Park JY, Kim JY, et al. Elevated serum ceruloplasmin levels in subjects with metabolic syndrome: a population-based study. Metabolism. 2002;51:838–42.
  • Lee MJ, Jung CH, Kang YM, Jang JE, Leem J, Park JY, et al. Serum ceruloplasmin level as a predictor for the progression of diabetic nephropathy in Korean men with type 2 diabetes mellitus. Diabetes Metab. 2015;39:230–9.
  • Moura Neto A, Wittmann DE, Fernandes TD, Nery M, Parisi MC. Risk factors for ulceration and amputation in diabetic foot: study in a cohort of 496 patients. Endocrine. 2013;44:119–24.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.