Prevalence and Medical Resource of Patients with Diabetic Foot Ulcer: A Nationwide Population-Based Retrospective Cohort Study for 2001–2015 in Taiwan

Abstract

Diabetic foot ulcer (DFU) is one of the common complications of diabetes. DFU can cause a huge medical and financial burden due to infections, compromise the quality of life, and increase the mortality rate in patients. However, the consumption of medical resources for DFU is rarely mentioned. A retrospective cohort study was performed. Data were obtained from the National Health Insurance Research Database of Taiwan, and the prevalence and medical utilization data for DFU in 2001–2015 were extracted, followed by the analysis for high-risk populations. Between 2001 and 2015, there were 7511 new DFU patients. A higher proportion in these patients was male, elderly with a low education level, and low income. Between 2001 and 2015, the prevalence of DFU was 0.5–0.8%, and the number of DFU patients showed stable growth. Every year, 12.6–19.3% and 1.2–7.0% of patients underwent debridement and amputation, respectively. The hospitalization fees increased year on year. Our study showed that the DFU prevalence increased year on year, and the DFU medical expenditure increased. DFU tends to occur in males, patients with low socioeconomic status, low education level, those with multiple comorbidities, and old age. Therefore, DFU care and prevention require the entire healthcare system to jointly formulate a prevention plan.

Establishment and validation of a nomogram for progression to diabetic foot ulcers in elderly diabetic patients

“…Older patients with diabetic foot should receive more attention because they are always accompanied by other diseases and also, some studies have found that older diabetic patients are at higher risk of developing diabetic foot ulcers and their incidence may be higher ( 19 ). The prevalence of diabetic foot is not low, roughly 6% ( 17 ).…”

Wound healing and healing process in patients with diabetic foot ulcers: A survival analysis study

“…Diabetic foot ulcers (DFUs) are a severe and common complication of diabetes mellitus (DM), with a lifetime incidence that ranges from 15 to 25% among individuals with diabetes [1]. As the prevalence of diabetes increases all over the world, the number of patients with a DFU is also growing [2], making it a global public health issue [3]. In fact, DFUs are a leading cause of hospitalization in patients with DM [4], often preceding infection, lower extremity amputation or, ultimately, premature death [5][6].…”

Cobalt protoporphyrin promotes human keratinocyte migration under hyperglycemic conditions

“…Diabetes is a classic example of a chronic disease that continues to be a financial burden to many countries’ healthcare systems. It has been estimated that in Taiwan, a country that has a high prevalence of diabetic mellitus (DM), ~ 15% of DM patients suffer from diabetic wounds (Tai et al 2021 ). On average, these patients can spend 12.7 ± 11.8 days in hospitals (Cheng et al 2019 ), which can incur a huge cost to most patients and their families, both financially and emotionally.…”

“…To date, stem cell therapy is the most effective method of treating any diabetic wound, as treatment enhances re-epithelization and angiogenesis, and downregulates profound immune response (Carstens et al 2021 ). However, the cost per treatment is enormous, especially when most of the patients with diabetic wounds are characterized as low income (Tai et al 2021 ). Accordingly, there is a growing need for non-stem cell related therapy that could be used as a cheaper alternative for patients that with less severe diabetic wounds (Li et al 2021 ).…”