{"title":"Prevalence and risk factors associated with diabetic foot ulcer in India: a systematic review and meta-analysis","authors":"Swastik Subhankar Sahu, Vaibhav Chaudhary, Neha Sharma, Sweta Kumari, Biplab Pal, Navneet Khurana","doi":"10.1007/s13410-024-01400-x","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objective</h3><p>Diabetes mellitus is a prevalent chronic health condition associated with high blood glucose levels. Among its complications, diabetic foot ulcers (DFUs) are particularly concerning due to their potential for infection and lower extremity amputation. In India, where diabetes prevalence is high and rising, understanding the prevalence and risk factors of DFUs is essential for effective healthcare planning and intervention strategies.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A search was conducted across PubMed, Scopus, Embase, and Google Scholar to identify studies reporting the prevalence of DFUs published until December 2023. Statistical analysis was performed using R software, employing a random effects model with a 95% confidence interval. Publication bias was assessed via funnel plot visualization and Egger’s test. Subgroup analyses were conducted based on different variables. Moreover, determinants associated with DFUs were also assessed qualitatively.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Eighteen studies involving a total of 55,988 people with diabetes were included. The pooled prevalence of DFUs in India was estimated at 6.2% (95% CI: 4.0; 9.4%). Subgroup analysis revealed a higher prevalence in males (14.5%) compared to females (7.7%), although not statistically significant (<i>p</i> = 0.17). Regional analysis indicated similar prevalence in the East (9.5%), South (7.4%), and North (5.6%) regions of India (<i>p</i> = 0.42). Hospital-based studies exhibited a higher prevalence (7.5%) compared to community-based studies (2.5%) (<i>p</i> = 0.02). Longer diabetes duration, male gender, older age, comorbidities, and an unhealthy lifestyle were identified as major risk factors for DFUs.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The relatively low yet considerable prevalence of DFUs in India emphasizes the need for preventive strategies. The findings advocate for policymakers to prioritize interventions focusing on patient education, lifestyle modifications, and regular healthcare follow-up to reduce the burden of DFUs and improve outcomes in people with diabetes.</p>","PeriodicalId":50328,"journal":{"name":"International Journal of Diabetes in Developing Countries","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Diabetes in Developing Countries","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13410-024-01400-x","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
Diabetes mellitus is a prevalent chronic health condition associated with high blood glucose levels. Among its complications, diabetic foot ulcers (DFUs) are particularly concerning due to their potential for infection and lower extremity amputation. In India, where diabetes prevalence is high and rising, understanding the prevalence and risk factors of DFUs is essential for effective healthcare planning and intervention strategies.
Methods
A search was conducted across PubMed, Scopus, Embase, and Google Scholar to identify studies reporting the prevalence of DFUs published until December 2023. Statistical analysis was performed using R software, employing a random effects model with a 95% confidence interval. Publication bias was assessed via funnel plot visualization and Egger’s test. Subgroup analyses were conducted based on different variables. Moreover, determinants associated with DFUs were also assessed qualitatively.
Results
Eighteen studies involving a total of 55,988 people with diabetes were included. The pooled prevalence of DFUs in India was estimated at 6.2% (95% CI: 4.0; 9.4%). Subgroup analysis revealed a higher prevalence in males (14.5%) compared to females (7.7%), although not statistically significant (p = 0.17). Regional analysis indicated similar prevalence in the East (9.5%), South (7.4%), and North (5.6%) regions of India (p = 0.42). Hospital-based studies exhibited a higher prevalence (7.5%) compared to community-based studies (2.5%) (p = 0.02). Longer diabetes duration, male gender, older age, comorbidities, and an unhealthy lifestyle were identified as major risk factors for DFUs.
Conclusions
The relatively low yet considerable prevalence of DFUs in India emphasizes the need for preventive strategies. The findings advocate for policymakers to prioritize interventions focusing on patient education, lifestyle modifications, and regular healthcare follow-up to reduce the burden of DFUs and improve outcomes in people with diabetes.
期刊介绍：
International Journal of Diabetes in Developing Countries is the official journal of Research Society for the Study of Diabetes in India. This is a peer reviewed journal and targets a readership consisting of clinicians, research workers, paramedical personnel, nutritionists and health care personnel working in the field of diabetes. Original research articles focusing on clinical and patient care issues including newer therapies and technologies as well as basic science issues in this field are considered for publication in the journal. Systematic reviews of interest to the above group of readers are also accepted.
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