Zhang, Yuqi, Lazzarini, Pete A., McPhail, Steve M., van Netten, Jaap J., Armstrong, David G. and Pacella, Rosana E. ORCID: 0000-0002-9742-1957 (2020) The global disability burden of diabetes-related lower extremity complications, in 1990 and 2016. Diabetes Care, 43 (5). pp. 964-974. ISSN 0149-5992 (Print), 1935-5548 (Online) (doi:https://doi.org/10.2337/dc19-1614)

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Abstract

Objective:
No study has reported global disability burden estimates for individual diabetes-related lower extremity complications (DRLECs). The Global Burden of Diseases (GBD) study presents a robust opportunity to address this gap.

Research Design and Methods:
GBD 2016 data including prevalence and years lived with disability (YLDs) for the DRLECs of diabetic neuropathy, foot ulcer, and amputation with, and without prosthesis were used. GBD estimated prevalence using data from systematic reviews and DisMod-MR 2.1, a Bayesian meta-regression tool. YLDs were estimated as the product of prevalence estimates and disability weights for each DRLEC. We reported global, sex-, age-, region- and country-specific estimates for each DRLEC for 1990 and 2016.

Results:
In 2016, an estimated 131 million (1.8% of the global population) had DRLECs. An estimated 16.8 million YLDs (2.1% global YLDs) were caused by DRLECs, including 12.9 million (95% uncertainty interval: 8.30 to 18.8) from neuropathy only, 2.5 million (1.7 to 3.6) foot ulcers, 1.1 million (0.7 to 1.4) amputation without prosthesis, and 0.4 million (0.3 to 0.5) amputation with prosthesis. Age-standardised YLDs rates of all DRLECs increased by between 14.6% to 31.0% from 1990 estimates. Male-to-female YLD ratios ranged from 0.96 for neuropathy only to 1.93 for foot ulcers. Aged groups 50-69 years accounted for 47.8% of all YLDs from DRLECs.

Conclusions:
These first ever global estimates suggest DRLECs are a large and growing contributor to the disability burden worldwide, and disproportionately affect males and middle-to-older aged populations. These findings should facilitate policymakers worldwide to target strategies at populations disproportionately affected by DRLECs.

Item Type:	Article
Uncontrolled Keywords:	diabetic foot ulcer, diabetes-related lower extremity complications, burden of disease, global
Subjects:	R Medicine > R Medicine (General)
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development
Last Modified:	05 Jun 2020 14:33
URI:	http://gala.gre.ac.uk/id/eprint/26858

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