Diabetic Foot Ulcers, Peripheral Artery Disease and Critical Limb Ischemia, 2010

Over 40% of the U.S. adult population currently suffers from diabetes and prediabetes. Diabetic foot ulcers (DFU) and the resulting lower extremity amputations are a frequent, disabling and costly complication of diabetes. During their lifetime between 15% and 25% of diabetics will develop a foot ulcer.

Although a considerable amount of research has been published on diabetic foot ulcers (DFU), research on ischemic ulcers is relative new. Recent research indicates that diabetic ulcers in individuals with peripheral artery disease (PAD) are a different disease than in ulcers caused by neuropathy alone.

Among other differences from purely neuropathic ulcers, DFU in patients with PAD tend to be more severe, are more likely to be infected, are infected by different pathogens, heal less frequently and are more costly to treat, primarily because of a greater number of hospitalizations. All of these factors have implications for the type and success of therapies employed as well as for the economic burden.

This report provides the first detailed statistical analysis of diabetic foot ulcers in the United States as well as the specific prevalence and incidence of ischemic and neuroischemic ulcers for the 2005-2030 periods. Population-based estimates of the prevalence of all diabetic foot ulcers are provided for the years 2005-2030. These age-based estimates are based on the most recently reported diabetes statistics. Incidence (the number of new DFU) is also included.

The prevalence and incidence of neuropathic, ischemic and neuroischemic diabetic foot ulcers are analyzed and estimated for the years 2005 through 2030. Infection and the types of infection found in foot ulcers are assessed. The prevalence and incidence of infected ischemic and neuroischemic ulcers are projected through 2030.

Peripheral artery disease represents a significant risk factor for diabetic foot ulcers and for adverse outcomes. In addition to a review of the current scientific literature, the report presents a comprehensive statistical analysis of the prevalence and incidence of PAD and critical limb ischemia (CLI) in diabetic foot ulcer patients for the 2005-2030 periods.

The characteristics of ischemic ulcers are detailed and analyzed. These include location, presence of multiple ulcers, healing amputation and mortality. An overview of the economic costs of diabetic foot ulcers as well as the specific higher costs of ischemic ulcers is included.

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