Declining Trends: Incidence, Hospitalization, and Mortality in First-Ever Diabetic Foot Ulcers
Summary: This retrospective analysis from the UK’s CPRD GOLD primary care database (2007–2017) examines the incidence, hospitalization, and mortality trends for first-ever diabetic foot ulcers (DFUs) in 129,624 people with diabetes. For type 2 diabetes, the mean incidence rate was 2.5 per 1,000 person-years, with significant annual declines (IRR 0.97), alongside reduced hospitalization (8.2% average, OR 0.89) and 1-year mortality (11.7%, OR 0.94). No similar improvements were seen in type 1 diabetes (incidence 1.6 per 1,000 person-years). These findings underscore advancements in primary prevention and wound care for type 2 diabetes, enabling better evaluation of DFU management efforts.
Key Highlights:
- Incidence of first DFUs: 2.5 [95% CI: 2.1–2.9] per 1,000 person-years in type 2 diabetes; declined by 3% annually (IRR 0.97 [0.96–0.99]).
- Type 1 diabetes showed stable incidence at 1.6 [1.3–1.9] per 1,000 person-years (IRR 0.96 [0.89–1.04]).
- Hospitalization rates for type 2 diabetes averaged 8.2% [SD 4.7], with a 11% annual decline (OR 0.89 [0.84–0.94]).
- One-year all-cause mortality for type 2 diabetes was 11.7% [SD 2.2], decreasing 6% annually (OR 0.94 [0.89–0.99]).
- Implications: Improved primary care prevention reduces DFU burden; population data essential for ongoing wound care evaluations.
Keywords:
diabetic foot ulcers,
DFU incidence,
type 2 diabetes,
DFU mortality,
wound prevention