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Trends in diabetes-related foot disease hospitalizations and amputations in Australia, 2010 to 2019

  • Author Footnotes
    1 Matthew Quigley and Jedidiah Morton are co-first authors.
    Matthew Quigley
    Correspondence
    Corresponding author at: School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
    Footnotes
    1 Matthew Quigley and Jedidiah Morton are co-first authors.
    Affiliations
    School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
    Search for articles by this author
  • Author Footnotes
    1 Matthew Quigley and Jedidiah Morton are co-first authors.
    Jedidiah I. Morton
    Footnotes
    1 Matthew Quigley and Jedidiah Morton are co-first authors.
    Affiliations
    School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

    Baker Heart and Diabetes Institute, Melbourne, Australia

    Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
    Search for articles by this author
  • Peter A. Lazzarini
    Affiliations
    School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia

    Australian Centre for Health Services Innovation & Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia

    Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Australia
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  • Sophia Zoungas
    Affiliations
    School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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  • Author Footnotes
    2 Jonathan E Shaw and Dianna J Magliano are co-senior authors.
    Jonathan E. Shaw
    Footnotes
    2 Jonathan E Shaw and Dianna J Magliano are co-senior authors.
    Affiliations
    School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

    Baker Heart and Diabetes Institute, Melbourne, Australia
    Search for articles by this author
  • Author Footnotes
    2 Jonathan E Shaw and Dianna J Magliano are co-senior authors.
    Dianna J. Magliano
    Footnotes
    2 Jonathan E Shaw and Dianna J Magliano are co-senior authors.
    Affiliations
    School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

    Baker Heart and Diabetes Institute, Melbourne, Australia
    Search for articles by this author
  • Author Footnotes
    1 Matthew Quigley and Jedidiah Morton are co-first authors.
    2 Jonathan E Shaw and Dianna J Magliano are co-senior authors.
Published:November 25, 2022DOI:https://doi.org/10.1016/j.diabres.2022.110189

      Abstract

      Aim

      To determine trends in the incidence of hospitalizations and amputations for diabetes-related foot disease (DFD) in Australia.

      Methods

      We included 70,766 people with type 1, and 1,087,706 with type 2 diabetes from the Australian diabetes registry from 2010 to 2019, linked to hospital admissions databases. Trends in age-adjusted incidence were summarized as annual percent changes (APC).

      Results

      In people with type 1 diabetes, total DFD hospitalizations increased from 20.8 to 30.5 per 1,000 person-years between 2010 and 2019 (APC: 5.1% (95% CI: 3.5, 6.8)), including increases for ulceration (13.3% (2.9, 24.7)), osteomyelitis (5.6% (2.7, 8.7)), peripheral arterial disease (7.7% (3.7, 11.9)), and neuropathy (8.7% (5.5, 12.0)). In people with type 2 diabetes, DFD hospitalizations changed from 18.6 to 24.8 per 1,000 person-years between 2010 and 2019 (APC: 4.5% (3.6, 5.4); 2012–2019), including increases for ulceration (8.7% (4.0, 13.7)), cellulitis (5.4% (3.7, 7.0)), osteomyelitis (6.7% (5.7, 7.7)), and neuropathy (6.9% (5.2, 8.5)). Amputations were stable in type 1, whereas in type 2, above knee amputations decreased (-6.0% (-9.1, −2.7). Adjustment for diabetes duration attenuated the magnitude of most increases, but many remained significant.

      Conclusions

      DFD hospitalizations increased markedly in Australia, mainly driven by ulceration and neuropathy, highlighting the importance of managing DFD to prevent hospitalizations.

      Keywords

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