Prevalence and Incidence of Diabetes-Related Peripheral Neuropathy, Peripheral Artery Disease, Foot Ulcers and Lower Extremity Amputations in Ireland; A Systematic Review.

Abstract

Introduction: Diabetes-related foot disease is a leading cause of global disease burden, however the prevalence and incidence of diabetes-related foot disease in Ireland is poorly understood. Up-to-date population-level estimates of the incidence and prevalence are imperative to support appropriate health service planning. This study examined the prevalence and incidence of diabetes-related foot disease in the Irish population.

Methods: We systematically searched Pubmed, EMBASE and Lenus the Irish Health Research repository, for peer-reviewed articles published until August 2025. Publications reporting on prevalence and incidence of peripheral neuropathy, peripheral artery disease, foot ulceration or amputation in people with diabetes in Ireland, were eligible for inclusion. The Joanna Briggs Institute Prevalence (JBI) Critical Appraisal Tool was used to assess included studies methodological quality and establish the degree to which bias was addressed in the study's design and analysis. Results were synthesised descriptively according to study characteristics and outcomes.

Results: Three studies met the inclusion criteria (n = 145,945), with varying outcome measurement methods. In community-based diabetes populations, peripheral neuropathy prevalence ranged from 15% to 39% (n = 1055) and peripheral artery disease prevalence ranged from 18% to 34% (n = 383). For the history of foot ulcers, prevalence was 3.7% (n = 563) and annual incidence was 2.6% (n = 383). One national population-based study (n = 144,710) reported incidence of amputation increased from 144.2 to 175.7 per 100,000 people with diabetes between 2005 and 2009.

Conclusion: This review found there is a paucity of information on prevalence and incidence of diabetes-related foot disease in Ireland. However, these findings suggest that prevalence is similar to, if not lower than, global rates of peripheral neuropathy, peripheral artery disease outcomes and amputation incidence outcomes. High heterogeneity in populations and outcomes highlights the need for robust studies and consensus on diabetes-related foot outcome assessment. Establishing a national diabetes register could strengthen surveillance, identify high-risk groups and inform cost-effective public health planning.

Trial registration: PROSPERO (CRD42023472904).