Diabetic foot ulcer incidence and survival with improved diabetic foot services: an 18‐year study

Aims To ascertain the effects of improvements in diabetic foot services over 18 years on incidence of diabetic foot ulceration. We also compared survival time from first ulcer development with presence of neuropathy, peripheral vascular disease, age and healing. Methods Persons with new ulceration a...

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Bibliographic Details
Published in:Diabetic medicine 2019-11, Vol.36 (11), p.1424-1430
Main Authors: Paisey, R. B., Abbott, A., Paisey, C. F., Walker, D., Birch, Rebecca, Bowen, Belinda, Brown, Roger, Clark, Cheryl, Collings, Richard, Cutts, Steve, Davies, Joanne, Ellin, Sean, Evans, Kerry‐Ann, Fisher, Rob, Glasser, Sam, Hillstead, Martyn, Hine, Gemma, Levi, Sarah, Martin, Amanda, Mackintosh, Lauren, Phillips, Sadie, Rawlinson, Ella, Shepperd, Anne‐Marie, Spicer, Kerrie, Stewart, Su, Stocker, Sam, Tailford, Harriet, Tansley, Justine, Uglow, Hannah, Widgery, Adam, Williams, Jen, Darke, Samuel
Format: Article
Language:English
Subjects:
Adult
Aged
Community Health Services - standards
Diabetes
Diabetes mellitus
Diabetic Angiopathies - mortality
Diabetic Angiopathies - physiopathology
Diabetic Angiopathies - therapy
Diabetic Foot - mortality
Diabetic Foot - physiopathology
Diabetic Foot - therapy
Diabetic Neuropathies - mortality
Diabetic Neuropathies - physiopathology
Diabetic Neuropathies - therapy
Diabetic neuropathy
Feet
Female
Follow-Up Studies
Foot diseases
Health Care Surveys
Health services
Humans
Incidence
Leg ulcers
Male
Middle Aged
Podiatry - standards
Proportional Hazards Models
Research: Care Delivery
Survival
Ulcers
Vascular diseases
Wound Healing - physiology
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Summary:Aims To ascertain the effects of improvements in diabetic foot services over 18 years on incidence of diabetic foot ulceration. We also compared survival time from first ulcer development with presence of neuropathy, peripheral vascular disease, age and healing. Methods Persons with new ulceration and those at high risk of ulcer development were referred to community podiatry from 1998. Their details were recorded, with verbal consent, on a central database. The effects of neuropathy, peripheral vascular disease, healing and age on survival were analysed by Cox proportional hazards ratios. Results The incidence of first ulcer presentation decreased from 11.1 to 6.1 per 1000 persons between 2003 to 2017 (P
ISSN:0742-3071
1464-5491
DOI:10.1111/dme.14045