Decline in diabetic foot ulcers in clinical practice

The incidence of foot ulcers developing in diabetes patients is decreasing, particularly in Type 2 diabetes, say researchers.

Presenting the findings at the European Association for the Study of Diabetes 48th Annual Meeting in Berlin, Germany, Anne Rasmussen from the Steno Diabetes Center in Gentofte, Denmark said incidence of first foot ulcers registered at the clinic has significantly decreased over the last 10 years in patients with both Type 1 and Type 2 diabetes.

At the specialized clinic, which is an integrated part of the public healthcare system, approximately 3500 patients with Type 1 diabetes and 2000 with complicated Type 2 diabetes are followed up with yearly feet inspections and determination of vibration threshold.

An analysis of the center's electronic database showed that, among diabetes patients overall, the incidence of the first registered foot ulcer significantly decreased, from 2.0 to 1.5 foot ulcers per 100 patient years between 2001 and 2011.

The effect was most pronounced in those with Type 2 diabetes, among whom incidence decreased by 3.5 to 2.0 per 100 patient years.

Most of the decreases were in neuropathic ulcers, while incidence of ischemic and neuroischemic ulcers remained relatively unchanged.

Rasmussen suggests that the organization of the clinic may underlie the decrease in incidence of foot ulcers there.

"We have very good continuity in the foot clinic at the moment, we have a better registration which means we are very much focused on the diabetes patients as a whole, and on foot inspections," he said

In the future, focus should be kept on education, information, and follow-up before and after registration of the first foot ulcer.

Life-long follow up of patients should also be organized, concludes Rassaman.

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