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Abstract
The global incidence of diabetes mellitus is increasing. Patients with diabetes are at increased lifetime risk of developing foot ulcers a major and increasing public health problem associated with morbidities, impairment of quality of life and increased management costs. As ＞ 85% of amputations are preceded by an active foot ulcer in patients with diabetes ulcers and amputation are considered together in this report. We examine the incidence of foot disorders in South Korea using disease-classification codes included on health insurance claim forms and data collected during a 5 year observational study in a university hospital. The annual incidence of diabetic foot disease is 1.0~1.2% in Korea. However, Korean epidemiological studies describing the clinical and surgical characteristics of diabetic foot wounds are lacking. The evaluation and treatmentof diabetic foot ulcers should be implemented in prospective cohort studies as soon as possible.
REFERENCES
1. Boulton AJ, Vileikyte L, Ragnarson-Tennvall G, Apelqvist J. The global burden of diabetic foot disease. Lancet. 2005; 366:1719–24.
2. Armstrong DG, Wrobel J, Robbins JM. Guest Editorial: are diabetes-related wounds and amputations worse than cancer? Int Wound J. 2007; 4:286–7.
3. Bharara M, Mills JL, Suresh K, Rilo HL, Armstrong DG. Diabetes and landmine-related amputations: a call to arms to save limbs. Int Wound J. 2009; 6:2–3.
4. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005; 293:217–28.
5. Boulton AJ. The diabetic foot: grand overview, epidemiology and pathogenesis. Diabetes Metab Res Rev. 2008; 24(Suppl 1):S3–6.
6. Deerochanawong C, Home PD, Alberti KG. A survey of lower limb amputation in diabetic patients. Diabet Med. 1992; 9:942–6.
7. Chung CH, Kim DJ, Kim JY, Kim HY, Kim HY, Min KW, Park SW, Park JH, Baik SH, Son HS, Ahn CW, Oh JY, Lee SH, Lee JY, Choi KM, Choi IJ, Park IB. Current status of diabetic foot in Korean patients using National Health Insurance database. J Korean Diabetes Assoc. 2006; 30:372–6.
8. Park SA, Ko SH, Lee SH, Cho JH, Moon SD, Jang SA, Son HS, Song KH, Cha BY, Son HY, Ahn YB. Incidence of diabetic foot and associated risk factors in type 2 diabetic patients: a five-year observational study. Korean Diabetes J. 2009; 33:315–23.
9. Diabetes care and research in Europe: the Saint Vincent declaration. Diabet Med. 1990; 7:360.
10. Oyibo SO, Jude EB, Tarawneh I, Nguyen HC, Armstrong DG, Harkless LB, Boulton AJ. The effects of ulcer size and site, patient's age, sex and type and duration of diabetes on the outcome of diabetic foot ulcers. Diabet Med. 2001; 18:133–8.
11. Global Lower Extremity Amputation Study Group. Epidemiology of lower extremity amputation in centres in Europe, North America and East Asia. The Global Lower Extremity Amputation Study Group. Br J Surg. 2000; 87:328–37.
12. Wits⊘ E, R⊘nningen H. Lower limb amputations: registration of all lower limb amputations performed at the University Hospital of Trondheim, Norway, 1994-1997. Prosthet Orthot Int. 2001; 25:181–5.
13. Calle-Pascual AL, Garcia-Torre N, Moraga I, Diaz JA, Duran A, Moñux G, Serrano FJ, Martín-Alvarez PJ, Charro A, Marañes JP. Epidemiology of nontraumatic lower-extremity amputation in area 7, Madrid, between 1989 and 1999: a population-based study. Diabetes Care. 2001; 24:1686–9.
14. Boyko EJ, Ahroni JH, Smith DG, Davignon D. Increased mortality associated with diabetic foot ulcer. Diabet Med. 1996; 13:967–72.
15. Lavery LA, van Houtum WH, Harkless LB. In-hospital mortality and disposition of diabetic amputees in The Netherlands. Diabet Med. 1996; 13:192–7.
16. da Silva AF, Desgranges P, Holdsworth J, Harris PL, McCollum P, Jones SM, Beard J, Callam M. The management and outcome of critical limb ischaemia in diabetic patients: results of a national survey. Audit Committee of the Vascular Surgical Society of Great Britain and Ireland. Diabet Med. 1996; 13:726–8.
17. Apelqvist J, Larsson J, Agardh CD. Longterm prognosis for diabetic patients with foot ulcers. J Intern Med. 1993; 233:485–91.
18. Faglia E, Favales F, Morabito A. New ulceration, new major amputation, and survival rates in diabetic subjects hospitalized for foot ulceration from 1990 to 1993: a 6.5-year follow-up. Diabetes Care. 2001; 24:78–83.
19. Caravaggi C, Faglia E, De Giglio R, Mantero M, Quarantiello A, Sommariva E, Gino M, Pritelli C, Morabito A. Effectiveness and safety of a nonremovable fiberglass off-bearing cast versus a therapeutic shoe in the treatment of neuropathic foot ulcers: a randomized study. Diabetes Care. 2000; 23:1746–51.
20. Armstrong DG, Abu-Rumman PL, Nixon BP, Boulton AJ. Continuous activity monitoring in persons at high risk for diabetes-related lower-extremity amputation. J Am Podiatr Med Assoc. 2001; 91:451–5.
21. Margolis DJ, Kantor J, Berlin JA. Healing of diabetic neuropathic foot ulcers receiving standard treatment. A meta-analysis. Diabetes Care. 1999; 22:692–5.
Table 1.
The international working group on the diabetic foot risk classification system
| Authors | Country | Year | No. | Prevalence (%) | Incidence (%) | Risk factors for foot ulcers (%) | ||
|---|---|---|---|---|---|---|---|---|
| Ulcers | Amputation | Ulcers | Amputation | |||||
| Park et al. | Korea | 2009 | 508 | - | - | 1.0 | - | |
| Al-Mahroos and Al-Roomi | Bahrain | 2007 | 1,477 | 5.9 | - | - | - | 45 |
| Chung et al. | Korea | 2006 | 3,587,547 | - | - | 1.2 | 0.05 | |
| Reid et al. | Canadaa | 2006 | 169 | 5b | 3 | - | - | ＞ 42 |
| Abbott et al. | UK | 2002 | 9,710 | 1.7 | 1.3 | 2.2 | - | ＞ 50 |
| Manes et al. | Greece | 2002 | 821 | 4.8 | - | - | - | ＞ 50 |
| Muller et al. | Netherlands | 2002 | 665 | - | - | 2.1 | 0.6 | - |
| Ramsey et al. | USA | 1999 | 8,965 | - | - | 5.8c | 0.9c | - |
| Vozar et al. | Slovakia | 1997 | 1,205 | 2.5 | 0.9 | 0.6 | 0.6 | - |
| Kumar et al. | UK | 1994 | 821 | 1.4d | - | - | - | 42 |
| Moss et al. | USA | 1992 | 2,900 | - | - | 10.1e | 2.1e | - |
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