title: Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis†.
abstract: Diabetic foot is a severe public health issue, yet rare studies investigated its global epidemiology. Here we performed a systematic review and meta-analysis through searching PubMed, EMBASE, ISI Web of science, and Cochrane database. We found that that global diabetic foot ulcer prevalence was 6.3% (95%CI: 5.4-7.3%), which was higher in males (4.5%, 95%CI: 3.7-5.2%) than in females (3.5%, 95%CI: 2.8-4.2%), and higher in type 2 diabetic patients (6.4%, 95%CI: 4.6-8.1%) than in type 1 diabetics (5.5%, 95%CI: 3.2-7.7%). North America had the highest prevalence (13.0%, 95%CI: 10.0-15.9%), Oceania had the lowest (3.0%, 95% CI: 0.9-5.0%), and the prevalence in Asia, Europe, and Africa were 5.5% (95%CI: 4.6-6.4%), 5.1% (95%CI: 4.1-6.0%), and 7.2% (95%CI: 5.1-9.3%), respectively. Australia has the lowest (1.5%, 95%CI: 0.7-2.4%) and Belgium has the highest prevalence (16.6%, 95%CI: 10.7-22.4%), followed by Canada (14.8%, 95%CI: 9.4-20.1%) and USA (13.0%, 95%CI: 8.3-17.7%). The patients with diabetic foot ulcer were older, had a lower body mass index, longer diabetic duration, and had more hypertension, diabetic retinopathy, and smoking history than patients without diabetic foot ulceration. Our results provide suggestions for policy makers in deciding preventing strategy of diabetic foot ulceration in the future. Key messages Global prevalence of diabetic foot is 6.3% (95%CI: 5.4-7.3%), and the prevalence in North America, Asia, Europe, Africa and Oceania was 13.0% (95%CI: 10.0-15.9%), 5.5% (95%CI: 4.6-6.4%), 5.1% (95%CI: 4.1-6.0%), 7.2% (95%CI: 5.1-9.3%), and 3.0% (95% CI: 0.9-5.0%). Diabetic foot was more prevalent in males than in females, and more prevalent in type 2 diabetic foot patients than in type 1 diabetic foot patients. The patients with diabetic foot were older, had a lower body mass index, longer diabetic duration, and had more hypertension, diabetic retinopathy, and smoking history than patients without diabetic foot.
authors: a Department of Endocrinology , Nanjing Drum Tower Hospital affiliated to Nanjing University Medical School , Nanjing , China.
authors: Pengzi
authors: P
authors: Zhang
authors: a Department of Endocrinology , Nanjing Drum Tower Hospital affiliated to Nanjing University Medical School , Nanjing , China.
authors: Jing
authors: J
authors: Lu
authors: a Department of Endocrinology , Nanjing Drum Tower Hospital affiliated to Nanjing University Medical School , Nanjing , China.
authors: Yali
authors: Y
authors: Jing
authors: a Department of Endocrinology , Nanjing Drum Tower Hospital affiliated to Nanjing University Medical School , Nanjing , China.
authors: Sunyinyan
authors: S
authors: Tang
authors: a Department of Endocrinology , Nanjing Drum Tower Hospital affiliated to Nanjing University Medical School , Nanjing , China.
authors: Dalong
authors: D
authors: Zhu
authors: a Department of Endocrinology , Nanjing Drum Tower Hospital affiliated to Nanjing University Medical School , Nanjing , China.
authors: Yan
authors: Y
authors: Bi
mesh_terms: D000328:Adult; D000349:Africa / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D015992:Body Mass Index; D003657:Decision Making; D048909:Diabetes Complications / Q000473:pathology*; D017719:Diabetic Foot / Q000191:economics / Q000453:epidemiology* / Q000473:pathology; D003930:Diabetic Retinopathy / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D016523:Foot Ulcer / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
keywords: Diabetic foot; epidemiology; global; prevalence