Global Disability Burdens of Diabetes-Related Lower-Extremity Complications in 1990 and 2016

Abstract

Objective No study has reported global disability burden estimates for individual diabetesrelated 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. ResultsIn 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.

Biomimetic Approaches for Separated Regeneration of Sensory and Motor Fibers in Amputee People: Necessary Conditions for Functional Integration of Sensory–Motor Prostheses With the Peripheral Nerves

“…Although many of the cases of amputations are trauma-related [2879 patients between 2011 and 2012 in the United States (Low et al, 2017)], the leading cause continues to be diabetes mellitus, with more than 1.5 million lower amputations worldwide, with 1.1 million being without prosthesis (Zhang et al, 2020).…”

The Potential Role of Sensors, Wearables and Telehealth in the Remote Management of Diabetes-Related Foot Disease

“…Diabetes-related foot disease (DFD), including foot ulcers, infection and gangrene, is one of the 10 leading causes of the global disability burden [1]. About 40% of people who develop DFD Legend: The table outlines the risk factors for the development of diabetes-related foot disease and how sensors and wearables could be used to remotely monitor these factors.…”

Effects of training podiatrists to use imagery-based motivational interviewing to improve self-care for people with diabetes-related foot disease: A mixed-methods pilot study

“…Around half of these ulcers become complicated by infection, often leading to hospitalisation, amputation and increased mortality (2). This all contributes to DFD being a leading cause of the global burden of disability (4,5), yet, up to 90% of this burden may be prevented when evidence-based clinical care is optimised (6,7).…”