The diabetic foot: epidemiology.
The epidemiology of the diabetic foot is still unknown because this heterogeneous pathologic condition is non uniformly classified and described. Lower limb peripheral vascular disease has a preferential distal location strongly associated with the classical factors of cardiovascular risk. Ulcers occur in 15% of diabetics and 6-20% of all hospitalized diabetic patients are affected by ulcers of the foot. There is a predictive feature of the severity of the ulcer in relation to its location. In the USA, ischemia-related amputations are about 200 per million per year for non diabetics as against 3900 per million for diabetics; furthermore the incidence of a second amputation rises to 51% 5 years after first amputation. Risk factors for amputation are: smoking, hypertension, dyslipidemia, elderly age, glycosylated hemoglobin levels. Although mortality has decreased in the last 50 years, the diabetic foot is still a huge economic problem.
Mancini
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Istituto di Medicina Interna e Geriatria, Università Cattolica del S.Cuore, Policlinico A.Gemelli, Roma, Italy.
Ruotolo
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D000671:Amputation, Surgical; D003365:Costs and Cost Analysis; D017719:Diabetic Foot / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D014481:United States / Q000453:epidemiology