The prevalence of foot ulcers in diabetic patients in Pakistan: A systematic review and meta-analysis

Abstract

We aimed to determine the pooled prevalence of diabetic foot ulcers in Pakistan. MEDLINE (PubMed), Web of Science, Google scholars, and local databases were systematically searched for studies published up to August 10, 2022, on the prevalence of foot ulcers among diabetic patients in Pakistan. Random-effects meta-analysis was used to generate summary estimates. Subgroup analysis and meta-regression models were used to address the issue of high heterogeneity. Two authors independently identified eligible articles, collected data, and performed a risk of bias analysis. Twelve studies were included in the meta-analysis (14201, range 230–2199, diabetic patients), of which 7 were of “high” quality. The pooled prevalence of diabetic foot ulcers was 12.16% (95% CI: 5.91–20.23%). We found significant between-study heterogeneity (I2 = 99.3%; p < 0.001) but no statistical evidence of publication bias (p = 0.8544). Subgroup meta-analysis found significant differences in foot ulcer prevalence by publication year and by the duration of diabetes. An increasing trend was observed during the last two decades, with the prevalence of diabetic foot ulcers being the highest in the latest period from 2011 to 2022 (19.54%) than in the early 2000 s (4.55%). This study suggests that the prevalence of diabetic foot ulcers in Pakistan is relatively high, with significant variation between provinces. Further study is required to identify ways for early detection, prevention, and treatment in the population.

Early Detection of Diabetic Neuropathy Based on Health Belief Model: A Scoping Review

“…Patients apply the health belief model in preventing complications of diabetes mellitus . Diabetic neuropathy is the most frequent complication of diabetes mellitus (Akhtar et al, 2023).…”

“…Diabetes mellitus may cause complications of diabetic, retinopathic, and nephrotic neuropathy. Diabetic neuropathy is the most common complication in type 2 diabetes mellitus (Akhtar et al, 2023). Diabetic neuropathy occurs in the sensory, motor, and autonomic nervous systems (Saranya et al, 2019).…”

Comparative analysis of surgical and non‐surgical wound approaches in diabetic foot ulcer treatment: Meta‐analysis and systematic review

“…The increasing prevalence of diabetes on the global scale was anticipated to lead to the greater burden of DFUs, thereby intensifying the urgency for treatment strategies that are effective. 1,11 Gaining insight into the relative merits and drawbacks of surgical and non-surgical methodologies may result in provision of more individualized and efficacious treatment for individuals afflicted with DFUs. 12,13 In addition, given the evolution of medical technologies and treatment modalities, this analysis is timely and pertinent.…”

“…The research holds great importance due to its potential to inform and direct the development of policies and clinical decision‐making. The increasing prevalence of diabetes on the global scale was anticipated to lead to the greater burden of DFUs, thereby intensifying the urgency for treatment strategies that are effective 1,11 . Gaining insight into the relative merits and drawbacks of surgical and non‐surgical methodologies may result in provision of more individualized and efficacious treatment for individuals afflicted with DFUs 12,13 …”

The High Re-Ulceration Rate in Lower Extremity Amputation Intervention in Type 2 Diabetic Vietnamese Patients After 24-Month Follow-Up at Cho Ray Hospital, Vietnam

“…Our study was subject to 2 principal constraints, namely: (1) The collection of data from DP records using an observational approach, as opposed to designed or intervention studies with predetermined sample size and enrollment, and adherence to all research protocols throughout the duration of the study; (2) The acquisition of a significant number of T2DPs with complete data after 24 months was nearly unattainable for observational studies, resulting in a limited number of T2DPs for detecting statistical differences.…”