Trends in diabetes-related foot disease hospitalizations and amputations in Australia, 2010 to 2019. (December 2022)

• Record Type: Journal Article
• Authors: Quigley, Matthew; Morton, Jedidiah I.; Lazzarini, Peter A.; Zoungas, Sophia; Shaw, Jonathan E.; Magliano, Dianna J.
• Is Part Of: Diabetes research and clinical practice. Volume 194(2022)
• Publication Date: 2022-12
• Subjects: Amputation -- Diabetes-related foot disease -- Epidemiology -- Hospitalization -- Trends -- Type 1 diabetes mellitus -- Type 2 diabetes mellitus; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2022.110189
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aim: To determine trends in the incidence of hospitalizations and amputations for diabetes-related foot disease (DFD) in Australia. Methods: We included 70, 766 people with type 1, and 1, 087, 706 with type 2 diabetes from the Australian diabetes registry from 2010 to 2019, linked to hospital admissions databases. Trends in age-adjusted incidence were summarized as annual percent changes (APC). Results: In people with type 1 diabetes, total DFD hospitalizations increased from 20.8 to 30.5 per 1, 000 person-years between 2010 and 2019 (APC: 5.1% (95% CI: 3.5, 6.8)), including increases for ulceration (13.3% (2.9, 24.7)), osteomyelitis (5.6% (2.7, 8.7)), peripheral arterial disease (7.7% (3.7, 11.9)), and neuropathy (8.7% (5.5, 12.0)). In people with type 2 diabetes, DFD hospitalizations changed from 18.6 to 24.8 per 1, 000 person-years between 2010 and 2019 (APC: 4.5% (3.6, 5.4); 2012–2019), including increases for ulceration (8.7% (4.0, 13.7)), cellulitis (5.4% (3.7, 7.0)), osteomyelitis (6.7% (5.7, 7.7)), and neuropathy (6.9% (5.2, 8.5)). Amputations were stable in type 1, whereas in type 2, above knee amputations decreased (-6.0% (-9.1, −2.7). Adjustment for diabetes duration attenuated the magnitude of most increases, but many remained significant. Conclusions: DFD hospitalizations increased markedly in Australia, mainly driven by ulceration and neuropathy, highlighting the importance of managing DFD to prevent hospitalizations.