Diabetic foot ulcer
A review of the challenges of the diabetic foot
With the anticipated global increase in diabetes from 366 million in 2011 to 552 million in 2030, this equates to approximately three new cases every ten seconds or almost ten million per year.
The anticipated burden of foot disease will be alarmingly high and is a major problem for people with diabetes; the cumulative lifetime incidence may be as high as 25 percent (Singh, 2005). The requirement for robust, evidence-based prevention strategies has never been greater, and the target population must extend beyond those diabetic patients with established risk factors that may render them susceptible to foot ulceration and infection.
Diabetic foot problems are among the most serious and costly complications of diabetes. The rising prevalence of diabetes all over the world has brought with it an increase in the number of lower-limb amputations performed as a result of the disease. Epidemiological reports indicate that over one million amputations are performed on people with diabetes each year. This amounts to a leg being lost to diabetes somewhere in the world every 30 seconds. But the latest prevalence data of 2011 means that nowadays globally every 20 seconds a lower leg is lost due to diabetes (IWGDF, 2011).
Both ulcers and amputations have an enormous impact on people’s lives, often leading to reduced independence, social isolation and psychological stress.
Living with diabetes, or any long-term condition is challenging. People with diabetes have to juggle and manage their eating, physical activity, medication and injections. Self-management and education are truly at the heart of living with diabetes. Education is vital to address all aspects of diabetes; however, there are often psychosocial challenges to deliver effective education and the adoption behavioural changes.
Foot ulcer treatment accounts for between 12-20 percent of the total diabetes healthcare spend. Well-organized diabetic foot care teams, good diabetes control and well-informed self-care can achieve significant reductions in amputations.