Global Disability Burdens of Diabetes-Related Lower-Extremity Complications in 1990 and 2016
No study has reported global disability burden estimates for individual diabetes-related lower-extremity complications (DRLECs). The Global Burden of Disease (GBD) study presents a robust opportunity to address this gap. GBD 2016 data, including prevalence and years lived with disability (YLDs), for...
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Published in | Diabetes care Vol. 43; no. 5; pp. 964 - 974 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
American Diabetes Association
01.05.2020
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Subjects | |
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Abstract | No study has reported global disability burden estimates for individual diabetes-related lower-extremity complications (DRLECs). The Global Burden of Disease (GBD) study presents a robust opportunity to address this gap.
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. The 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 and sex-, age-, region-, and country-specific estimates for each DRLEC for 1990 and 2016.
In 2016, an estimated 131 million people (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 8.30-18.8) from neuropathy only, 2.5 million (1.7-3.6) from foot ulcers, 1.1 million (0.7-1.4) from amputation without prosthesis, and 0.4 million (0.3-0.5) from amputation with prosthesis. Age-standardized YLD rates of all DRLECs increased by between 14.6% and 31.0% from 1990 estimates. Male-to-female YLD ratios ranged from 0.96 for neuropathy only to 1.93 for foot ulcers. The 50- to 69-year-old age-group accounted for 47.8% of all YLDs from DRLECs.
These first-ever global estimates suggest that 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 policy makers worldwide to target strategies at populations disproportionately affected by DRLECs. |
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AbstractList | OBJECTIVE No study has reported global disability burden estimates for individual diabetes-related lower-extremity complications (DRLECs). The Global Burden of Disease (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. The 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 and sex-, age-, region-, and country-specific estimates for each DRLEC for 1990 and 2016. RESULTS In 2016, an estimated 131 million people (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 8.30–18.8) from neuropathy only, 2.5 million (1.7–3.6) from foot ulcers, 1.1 million (0.7–1.4) from amputation without prosthesis, and 0.4 million (0.3–0.5) from amputation with prosthesis. Age-standardized YLD rates of all DRLECs increased by between 14.6% and 31.0% from 1990 estimates. Male-to-female YLD ratios ranged from 0.96 for neuropathy only to 1.93 for foot ulcers. The 50- to 69-year-old age-group accounted for 47.8% of all YLDs from DRLECs. CONCLUSIONS These first-ever global estimates suggest that 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 policy makers worldwide to target strategies at populations disproportionately affected by DRLECs. No study has reported global disability burden estimates for individual diabetes-related lower-extremity complications (DRLECs). The Global Burden of Disease (GBD) study presents a robust opportunity to address this gap. 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. The 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 and sex-, age-, region-, and country-specific estimates for each DRLEC for 1990 and 2016. In 2016, an estimated 131 million people (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 8.30-18.8) from neuropathy only, 2.5 million (1.7-3.6) from foot ulcers, 1.1 million (0.7-1.4) from amputation without prosthesis, and 0.4 million (0.3-0.5) from amputation with prosthesis. Age-standardized YLD rates of all DRLECs increased by between 14.6% and 31.0% from 1990 estimates. Male-to-female YLD ratios ranged from 0.96 for neuropathy only to 1.93 for foot ulcers. The 50- to 69-year-old age-group accounted for 47.8% of all YLDs from DRLECs. These first-ever global estimates suggest that 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 policy makers worldwide to target strategies at populations disproportionately affected by DRLECs. OBJECTIVENo study has reported global disability burden estimates for individual diabetes-related lower-extremity complications (DRLECs). The Global Burden of Disease (GBD) study presents a robust opportunity to address this gap. RESEARCH DESIGN AND METHODSGBD 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. The 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 and sex-, age-, region-, and country-specific estimates for each DRLEC for 1990 and 2016. RESULTSIn 2016, an estimated 131 million people (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 8.30-18.8) from neuropathy only, 2.5 million (1.7-3.6) from foot ulcers, 1.1 million (0.7-1.4) from amputation without prosthesis, and 0.4 million (0.3-0.5) from amputation with prosthesis. Age-standardized YLD rates of all DRLECs increased by between 14.6% and 31.0% from 1990 estimates. Male-to-female YLD ratios ranged from 0.96 for neuropathy only to 1.93 for foot ulcers. The 50- to 69-year-old age-group accounted for 47.8% of all YLDs from DRLECs. CONCLUSIONSThese first-ever global estimates suggest that 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 policy makers worldwide to target strategies at populations disproportionately affected by DRLECs. |
Author | McPhail, Steven M Lazzarini, Peter A van Netten, Jaap J Pacella, Rosana E Zhang, Yuqi Armstrong, David G |
Author_xml | – sequence: 1 givenname: Yuqi orcidid: 0000-0002-3656-5383 surname: Zhang fullname: Zhang, Yuqi email: yuqi.zhang@hdr.qut.edu.au organization: Australian Centre for Health Services Innovation, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia – sequence: 2 givenname: Peter A orcidid: 0000-0002-8235-7964 surname: Lazzarini fullname: Lazzarini, Peter A organization: Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Queensland, Australia – sequence: 3 givenname: Steven M surname: McPhail fullname: McPhail, Steven M organization: Centre for Functioning and Health Research, Metro South Health, Brisbane, Queensland, Australia – sequence: 4 givenname: Jaap J surname: van Netten fullname: van Netten, Jaap J organization: Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands – sequence: 5 givenname: David G surname: Armstrong fullname: Armstrong, David G organization: Southwestern Academic Limb Salvage Alliance, Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA – sequence: 6 givenname: Rosana E surname: Pacella fullname: Pacella, Rosana E organization: Institute for Lifecourse Development, University of Greenwich, London, U.K |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32139380$$D View this record in MEDLINE/PubMed |
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PublicationDateYYYYMMDD | 2020-05-01 |
PublicationDate_xml | – month: 05 year: 2020 text: 2020-05-01 day: 01 |
PublicationDecade | 2020 |
PublicationPlace | United States |
PublicationPlace_xml | – name: United States – name: Alexandria |
PublicationTitle | Diabetes care |
PublicationTitleAlternate | Diabetes Care |
PublicationYear | 2020 |
Publisher | American Diabetes Association |
Publisher_xml | – name: American Diabetes Association |
References | Lavery (2022031300355008100_B37) 2019; 36 Khunkaew (2022031300355008100_B15) 2019; 28 United Nations Department of Economic and Social Affairs Population Dynamics (2022031300355008100_B33) 2013 Asano (2022031300355008100_B27) 2008; 32 Davie-Smith (2022031300355008100_B28) 2017; 41 Naghavi (2022031300355008100_B25) 2017; 390 Pezzin (2022031300355008100_B30) 2004; 85 Murray (2022031300355008100_B22) 2015; 386 Hay (2022031300355008100_B20) 2017; 390 Moore (2022031300355008100_B26) 1989 Fullman (2022031300355008100_B39) 2018; 391 Lavery (2022031300355008100_B8) 2006; 29 Zhang (2022031300355008100_B16) 2017; 49 Cho (2022031300355008100_B1) 2018; 138 Schaper (2022031300355008100_B11) 2016; 32 Vos (2022031300355008100_B35) 2016; 388 Kerr (2022031300355008100_B14) 2019; 36 Murray (2022031300355008100_B23) 2012; 380 Stevens (2022031300355008100_B24) 2016; 13 Pop-Busui (2022031300355008100_B6) 2017; 40 Skrepnek (2022031300355008100_B12) 2017; 40 Narres (2022031300355008100_B36) 2017; 12 Lazzarini (2022031300355008100_B13) 2017; 14 Carinci (2022031300355008100_B17) 2016; 53 Jordan (2022031300355008100_B31) 2012; 36 Pickwell (2022031300355008100_B10) 2015; 38 Huebschmann (2022031300355008100_B38) 2019; 62 Holman (2022031300355008100_B9) 2015; 32 Boulton (2022031300355008100_B4) 2005; 366 Lazzarini (2022031300355008100_B18) 2018; 35 Kassebaum (2022031300355008100_B21) 2016; 388 Armstrong (2022031300355008100_B5) 2017; 376 Schoppen (2022031300355008100_B29) 2003; 84 Gregg (2022031300355008100_B3) 2016; 4 Lavery (2022031300355008100_B7) 2003; 26 Wang (2022031300355008100_B32) 2017; 390 Vos (2022031300355008100_B19) 2017; 390 Harding (2022031300355008100_B2) 2019; 62 Salomon (2022031300355008100_B34) 2015; 3 |
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A critical appraisal of the data collection 2000-2011 by the Organization for Economic Cooperation and Development (OECD) publication-title: Acta Diabetol doi: 10.1007/s00592-016-0879-4 contributor: fullname: Carinci – volume: 41 start-page: 537 year: 2017 ident: 2022031300355008100_B28 article-title: Factors influencing quality of life following lower limb amputation for peripheral arterial occlusive disease: a systematic review of the literature publication-title: Prosthet Orthot Int doi: 10.1177/0309364617690394 contributor: fullname: Davie-Smith – volume: 62 start-page: 3 year: 2019 ident: 2022031300355008100_B2 article-title: Global trends in diabetes complications: a review of current evidence publication-title: Diabetologia doi: 10.1007/s00125-018-4711-2 contributor: fullname: Harding – volume: 390 start-page: 1084 year: 2017 ident: 2022031300355008100_B32 article-title: Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: a systematic analysis for the Global Burden of Disease Study 2016 publication-title: Lancet doi: 10.1016/S0140-6736(17)31833-0 contributor: fullname: Wang – volume: 4 start-page: 537 year: 2016 ident: 2022031300355008100_B3 article-title: The changing face of diabetes complications publication-title: Lancet Diabetes Endocrinol doi: 10.1016/S2213-8587(16)30010-9 contributor: fullname: Gregg – volume: 29 start-page: 1288 year: 2006 ident: 2022031300355008100_B8 article-title: Risk factors for foot infections in individuals with diabetes publication-title: Diabetes Care doi: 10.2337/dc05-2425 contributor: fullname: Lavery – year: 2013 ident: 2022031300355008100_B33 article-title: World Population Prospects: The 2012 Revision: Highlights and Advance Tables contributor: fullname: United Nations Department of Economic and Social Affairs Population Dynamics – volume: 391 start-page: 2236 year: 2018 ident: 2022031300355008100_B39 article-title: Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016 publication-title: Lancet doi: 10.1016/S0140-6736(18)30994-2 contributor: fullname: Fullman – volume: 36 start-page: 995 year: 2019 ident: 2022031300355008100_B14 article-title: The cost of diabetic foot ulcers and amputations to the National Health Service in England publication-title: Diabet Med doi: 10.1111/dme.13973 contributor: fullname: Kerr – start-page: 219 issue: 238 year: 1989 ident: 2022031300355008100_B26 article-title: Prosthetic usage following major lower extremity amputation publication-title: Clin Orthop Relat Res doi: 10.1097/00003086-198901000-00032 contributor: fullname: Moore – volume: 390 start-page: 1211 year: 2017 ident: 2022031300355008100_B19 article-title: Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016 publication-title: Lancet doi: 10.1016/S0140-6736(17)32154-2 contributor: fullname: Vos – volume: 84 start-page: 803 year: 2003 ident: 2022031300355008100_B29 article-title: Physical, mental, and social predictors of functional outcome in unilateral lower-limb amputees publication-title: Arch Phys Med Rehabil doi: 10.1016/S0003-9993(02)04952-3 contributor: fullname: Schoppen – volume: 36 start-page: 355 year: 2019 ident: 2022031300355008100_B37 article-title: Diabetic foot syndrome in the twenty-first century publication-title: Clin Podiatr Med Surg doi: 10.1016/j.cpm.2019.02.002 contributor: fullname: Lavery – volume: 32 start-page: 231 year: 2008 ident: 2022031300355008100_B27 article-title: Predictors of quality of life among individuals who have a lower limb amputation publication-title: Prosthet Orthot Int doi: 10.1080/03093640802024955 contributor: fullname: Asano – volume: 32 start-page: 7 year: 2016 ident: 2022031300355008100_B11 article-title: Prevention and management of foot problems in diabetes: a summary guidance for daily practice 2015, based on the IWGDF guidance documents publication-title: Diabetes Metab Res Rev doi: 10.1002/dmrr.2695 contributor: fullname: Schaper – volume: 32 start-page: 78 year: 2015 ident: 2022031300355008100_B9 article-title: Pilot study to assess measures to be used in the prospective audit of the management of foot ulcers in people with diabetes publication-title: Diabet Med doi: 10.1111/dme.12564 contributor: fullname: Holman – volume: 28 start-page: 1413 year: 2019 ident: 2022031300355008100_B15 article-title: Health-related quality of life among adults living with diabetic foot ulcers: a meta-analysis publication-title: Qual Life Res doi: 10.1007/s11136-018-2082-2 contributor: fullname: Khunkaew – volume: 388 start-page: 1603 year: 2016 ident: 2022031300355008100_B21 article-title: Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015 publication-title: Lancet doi: 10.1016/S0140-6736(16)31460-X contributor: fullname: Kassebaum – volume: 386 start-page: 2145 year: 2015 ident: 2022031300355008100_B22 article-title: Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition publication-title: Lancet doi: 10.1016/S0140-6736(15)61340-X contributor: fullname: Murray – volume: 26 start-page: 1435 year: 2003 ident: 2022031300355008100_B7 article-title: Diabetic foot syndrome: evaluating the prevalence and incidence of foot pathology in Mexican Americans and non-Hispanic whites from a diabetes disease management cohort publication-title: Diabetes Care doi: 10.2337/diacare.26.5.1435 contributor: fullname: Lavery – volume: 12 start-page: e0182081 year: 2017 ident: 2022031300355008100_B36 article-title: Incidence of lower extremity amputations in the diabetic compared with the non-diabetic population: a systematic review publication-title: PLoS One doi: 10.1371/journal.pone.0182081 contributor: fullname: Narres – volume: 3 start-page: e712 year: 2015 ident: 2022031300355008100_B34 article-title: Disability weights for the global burden of disease 2013 study publication-title: Lancet Glob Health doi: 10.1016/S2214-109X(15)00069-8 contributor: fullname: Salomon – volume: 38 start-page: 852 year: 2015 ident: 2022031300355008100_B10 article-title: Predictors of lower-extremity amputation in patients with an infected diabetic foot ulcer publication-title: Diabetes Care doi: 10.2337/dc14-1598 contributor: fullname: Pickwell – volume: 36 start-page: 430 year: 2012 ident: 2022031300355008100_B31 article-title: The cost of major lower limb amputation: a 12-year experience publication-title: Prosthet Orthot Int doi: 10.1177/0309364612441489 contributor: fullname: Jordan – volume: 13 start-page: e1002056 year: 2016 ident: 2022031300355008100_B24 article-title: Guidelines for accurate and transparent health estimates reporting: the GATHER statement publication-title: PLoS Med doi: 10.1371/journal.pmed.1002056 contributor: fullname: Stevens – volume: 40 start-page: 936 year: 2017 ident: 2022031300355008100_B12 article-title: Health care service and outcomes among an estimated 6.7 million ambulatory care diabetic foot cases in the U.S publication-title: Diabetes Care doi: 10.2337/dc16-2189 contributor: fullname: Skrepnek – volume: 62 start-page: 1761 year: 2019 ident: 2022031300355008100_B38 article-title: Sex differences in the burden of type 2 diabetes and cardiovascular risk across the life course publication-title: Diabetologia doi: 10.1007/s00125-019-4939-5 contributor: fullname: Huebschmann – volume: 390 start-page: 1260 year: 2017 ident: 2022031300355008100_B20 article-title: Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016 publication-title: Lancet doi: 10.1016/S0140-6736(17)32130-X contributor: fullname: Hay – volume: 14 start-page: 716 year: 2017 ident: 2022031300355008100_B13 article-title: The silent overall burden of foot disease in a representative hospitalised population publication-title: Int Wound J doi: 10.1111/iwj.12683 contributor: fullname: Lazzarini – volume: 380 start-page: 2197 year: 2012 ident: 2022031300355008100_B23 article-title: Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010 publication-title: Lancet doi: 10.1016/S0140-6736(12)61689-4 contributor: fullname: Murray – volume: 388 start-page: 1545 year: 2016 ident: 2022031300355008100_B35 article-title: Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015 publication-title: Lancet doi: 10.1016/S0140-6736(16)31678-6 contributor: fullname: Vos – volume: 40 start-page: 136 year: 2017 ident: 2022031300355008100_B6 article-title: Diabetic neuropathy: a position statement by the American Diabetes Association publication-title: Diabetes Care doi: 10.2337/dc16-2042 contributor: fullname: Pop-Busui – volume: 85 start-page: 723 year: 2004 ident: 2022031300355008100_B30 article-title: Use and satisfaction with prosthetic limb devices and related services publication-title: Arch Phys Med Rehabil doi: 10.1016/j.apmr.2003.06.002 contributor: fullname: Pezzin – volume: 49 start-page: 106 year: 2017 ident: 2022031300355008100_B16 article-title: Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis publication-title: Ann Med doi: 10.1080/07853890.2016.1231932 contributor: fullname: Zhang |
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Snippet | No study has reported global disability burden estimates for individual diabetes-related lower-extremity complications (DRLECs). The Global Burden of Disease... OBJECTIVE No study has reported global disability burden estimates for individual diabetes-related lower-extremity complications (DRLECs). The Global Burden of... OBJECTIVENo study has reported global disability burden estimates for individual diabetes-related lower-extremity complications (DRLECs). The Global Burden of... |
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SubjectTerms | Adult Age Aged Aged, 80 and over Amputation Amputation - statistics & numerical data Amputation - trends Bayesian analysis Complications Diabetes Diabetes Complications - epidemiology Diabetes mellitus Diabetes Mellitus - epidemiology Diabetic Foot - epidemiology Diabetic Neuropathies - epidemiology Diabetic neuropathy Disabled Persons - statistics & numerical data Estimates Feet Female Global Burden of Disease - history Global Burden of Disease - trends Global Health - history Global Health - trends History, 20th Century History, 21st Century Humans Leg ulcers Literature reviews Lower Extremity - pathology Male Middle Aged Populations Prevalence Prostheses Research design Ulcers |
Title | Global Disability Burdens of Diabetes-Related Lower-Extremity Complications in 1990 and 2016 |
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