Epidemiology and Economic Impact of Foot Ulcers

In the year 2005, most of the estimated 150 million people worldwide afflicted by diabetes mellitus lived in developing countries.1 Diabetic foot ulcers will complicate the disease in more than 15% of these people during their lifetimes.2,3 In prospective cohort studies conducted among those with diabetes, history of a foot ulcer increased the risk of subsequent amputation by twoto over three-fold.4,5 Foot ulcers precede more than 80% of non-traumatic lower limb amputations.6 In this chapter, we will review the definition of a ‘foot ulcer’ and the studies that estimate the incidence and prevalence of foot ulcers, making note of issues that need to be considered in their computation. We will also review risk factors for foot ulcers from wellconducted epidemiological studies, foot ulcer outcomes and the economic impact of foot ulcers.