Facts On Diabetes And The Foot

Prevalence, Complications and Prevention


Diabetes Prevalence:

Total number:

18.2 million people in the United States which represents 6.3% of the population.

Diagnosed: 13.0 million people
Undiagnosed: 5.2 million people

There are 1.3 million new cases of diabetes diagnosed each year in people age 20 years or older.

Diabetes is the sixth leading cause of death by disease in the United States.

Diabetes Prevalence by age

Age 60 years or older: 8.6 million, 18.3 percent of all people in this age group have diabetes

Age 20 years or older: 18.0 million, 8.7 percent of all people in this age group have diabetes

Under age 20: 206,000, 0.25 percent of all people in this age group have diabetes

Diabetes Prevalence by sex

In people 20 years or older:

Men: 8.7 million or 8.7 percent of all men have diabetes
Women: 9.3 million or 8.7 percent of all women have diabetes.

Diabetes Prevalence by race/ethnicity:

In people 20 years or older:

Non-Hispanic Whites: 12.5 million or 8.4 percent of all non-Hispanic whites have diabetes

African Americans: 2.7 million or 11.4 percent of all African Americans have diabetes, however, one-third of them do not know it. African Americans are 1.6 times more likely to have diabetes, than non-Hispanic whites of similar age. Twenty-five percent of African Americans between the ages of 65 and 74 have diabetes.  African Americans experience higher rates of amputation than Hispanic or white Americans with diabetes.

Hispanic/Latino Americans: 2.0 million or 10.2 percent have diabetes. Approximately 24 percent of Mexican Americans, 26 percent of Puerto Ricans, and 16 percent of Cuban Americans between the ages of 45 and 74 have diabetes.

Hispanic Americans are 1.5 times more likely to have diabetes than non-Hispanic whites of similar age.

American Indians and Alaska Natives: 14.9 percent of American Indians and Alaska Natives have diagnosed diabetes. On average, American Indians and Alaska Natives are 2.3 times as likely to have diagnosed diabetes as non-Hispanic whites of a similar age.

Complications of Diabetes Nerve Disease

About 60-70 percent of people with diabetes have mild to severe forms of diabetic nerve damage (which often includes impaired sensation or pain in the feet or hands, slowed digestion of food in the stomach, etc.) Severe forms of diabetic nerve damage can lead to lower extremity amputations.

Ulcers and Amputation

During their lifetime, 15 percent of people with diabetes will experience a foot ulcer and between 14 and 24 percent of those with a foot ulcer will require amputation. Diabetes is the leading cause of lower extremity amputations in the United States occurring among people with diabetes. Each year, more than 82,000 amputations are performed among people with diabetes.

After an amputation, the chance of another amputation within 3 to 5 years is as high as 50 percent. The 5 year mortality rate after amputation ranges from 39 to 68 percent.

Heart Disease and Stroke

People with diabetes are 2 to 4 times more likely to have heart disease which is present in 75 percent of diabetes-related deaths. The risk of stroke is 2 to 4 times higher in people with diabetes.

Kidney Disease

Diabetes is the leading cause of new cases of end-stage renal disease, accounting for about 44 percent of new cases.

Blindness

Diabetes is the leading cause of new cases of blindness in adults 20 to 74 years of age. Each year 12,000 to 24,000 people lose their sight because of diabetes.

Cost of Diabetes

The total annual cost for the more than 82,000 amputations is over $1.1 billion dollars. This cost does not include surgeons’ fees, rehabilitation costs, prostheses, time lost from work, and disability payments.

Foot disease is the most common complication of diabetes leading to hospitalization. In 1996, foot disease accounted for 6 percent of hospital discharges listing diabetes and lower extremity ulcers, and in 1996, the average hospital stay was 13.7 days. The average hospital reimbursement from Medicare for a lower extremity amputation was $13,512 and from private insurers $26,126. At the same time, rehabilitation was reimbursed at a rate of $7,000 to $21,000.

The risk for Type 2 diabetes increases with age.  Approximately 18.3 percent (8.6 million) of the United States population age 60 and older have diabetes.

Medicare provides coverage for therapeutic footwear such as, depth-inlay shoes, custom-molded shoes, and shoe inserts for people with diabetes who qualify under Medicare Part B.

Prevention and Treatment of Diabetes Foot Problems

According to the National Diabetes Education Program (NDEP), a partnership among the National Institutes of Health, the Centers for Disease Control and Prevention and over 200 organizations, including the American Podiatric Medical Association, comprehensive foot care programs can reduce amputation rates by 45% to 85%. A comprehensive foot care program would include:

  • Early identification of the high risk diabetic foot
  • Early diagnosis of foot problems
  • Early intervention to prevent further deterioration that may lead to amputation
  • Patient education for proper care of the foot and footwear