47 research outputs found
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The global disability burden of diabetes-related lower extremity complications, in 1990 and 2016
Objective:
No study has reported global disability burden estimates for individual diabetes-related lower extremity complications (DRLECs). The Global Burden of Diseases (GBD) study presents a robust opportunity to address this gap.
Research Design and Methods:
GBD 2016 data including prevalence and years lived with disability (YLDs) for the DRLECs of diabetic neuropathy, foot ulcer, and amputation with, and without prosthesis were used. GBD estimated prevalence using data from systematic reviews and DisMod-MR 2.1, a Bayesian meta-regression tool. YLDs were estimated as the product of prevalence estimates and disability weights for each DRLEC. We reported global, sex-, age-, region- and country-specific estimates for each DRLEC for 1990 and 2016.
Results:
In 2016, an estimated 131 million (1.8% of the global population) had DRLECs. An estimated 16.8 million YLDs (2.1% global YLDs) were caused by DRLECs, including 12.9 million (95% uncertainty interval: 8.30 to 18.8) from neuropathy only, 2.5 million (1.7 to 3.6) foot ulcers, 1.1 million (0.7 to 1.4) amputation without prosthesis, and 0.4 million (0.3 to 0.5) amputation with prosthesis. Age-standardised YLDs rates of all DRLECs increased by between 14.6% to 31.0% from 1990 estimates. Male-to-female YLD ratios ranged from 0.96 for neuropathy only to 1.93 for foot ulcers. Aged groups 50-69 years accounted for 47.8% of all YLDs from DRLECs.
Conclusions:
These first ever global estimates suggest DRLECs are a large and growing contributor to the disability burden worldwide, and disproportionately affect males and middle-to-older aged populations. These findings should facilitate policymakers worldwide to target strategies at populations disproportionately affected by DRLECs
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Diabetes-related foot disease in Australia: a systematic review of the prevalence and incidence of risk factors, disease and amputation in Australian populations
Background
Diabetes-related foot disease (DFD) is a leading cause of global hospitalisation, amputation and disability burdens; yet, the epidemiology of the DFD burden is unclear in Australia. We aimed to systematically review the literature reporting the prevalence and incidence of risk factors for DFD (e.g. neuropathy, peripheral artery disease), of DFD (ulcers and infection), and of diabetes-related amputation (total, minor and major amputation) in Australian populations.
Methods
We systematically searched PubMed and EMBASE databases for peer-reviewed articles published until December 31, 2019. We used search strings combining key terms for prevalence or incidence, DFD or amputation, and Australia. Search results were independently screened for eligibility by two investigators. Publications that reported prevalence or incidence of outcomes of interest in geographically defined Australian populations were eligible for inclusion. Included studies were independently assessed for methodological quality and key data were extracted by two investigators.
Results
Twenty publications met eligibility and were included. There was high heterogeneity for populations investigated and methods used to identify outcomes. We found within diabetes populations, the prevalence of risk factors ranged from 10.0–58.8%, of DFD from 1.2–1.5%, and the incidence of diabetes-related amputation ranged from 5.2–7.2 per 1000 person-years. Additionally, the incidence of DFD-related hospitalisation ranged from 5.2–36.6 per 1000 person-years within diabetes populations. Furthermore, within inpatients with diabetes, we found the prevalence of risk factors ranged from 35.3–43.3%, DFD from 7.0–15.1% and amputation during hospitalisation from 1.4–5.8%.
Conclusions
Our review suggests a similar risk factor prevalence, low but uncertain DFD prevalence, and high DFD-related hospitalisation and amputation incidence in Australia compared to international populations. These findings may suggest that a low proportion of people with risk factors develop DFD, however, it is also possible that there is an underestimation of DFD prevalence in Australia in the few limited studies, given the high incidence of hospitalisation and amputation because of DFD. Either way, studies of nationally representative populations using valid outcome measures are needed to verify these DFD-related findings and interpretations
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Factors associated with healing of diabetes-related foot ulcers: observations from a large prospective real-world cohort
Factors associated with healing of diabetes-related foot ulcers: observations from a large prospective real-world cohor