General Considerations of Diabetic Foot Ulcers

Diabetes and its subsequent complications, including diabetic foot disease, is a rapidly growing global health pandemic and a major financial burden on healthcare systems worldwide. The International Diabetes Federation estimated that over 463 million people suffer from diabetes in 2020 and that number will continue to grow to over 700 million people by 2045. Diabetes is the leading cause of foot pathology, causing foot ulcerations from neuropathy, infection, and ischemia. Indeed, most nontraumatic amputations in the United States and Canada are secondary to diabetic foot ulcers. Among people within the United States, up to 15% have active ulcers and 1 in 4 have a lifetime risk of developing a diabetic foot ulcer. Infection occurs in approximately half of diabetic foot ulcers, and many of these require amputation. Because of this, diabetic foot ulcers are one of the most costly aspects of diabetes care, and ulcer-related complications are the leading cause of hospitalization for diabetic patients. This global health pandemic has been shown to disproportionately affect people of certain ethnic, racial, and socioeconomic groups. Some 85% of patients presenting with a non-healing diabetic foot ulcer are at risk for a subsequent amputation. Due to this risk, multiple different strategies have been employed to aid in the management and treatment of the diabetic foot.