Low-Cost Management of Diabetic Foot

Diabetic foot ulcer disease in African continent: ‘From clinical care to implementation’ – Review of diabetic foot in last 60 years – 1960 to 2020

“…Diabetes imposes a heavy burden on the health services in most African countries. We previously estimated the expenses to both the patient and society of treating foot ulcers in five countries with widely varying health care practices, reimbursement policies, and gross domestic products [41,42]. It was estimated that in Tanzania the cost to the patient and relatives about $ 3,060 (International $: $Int), which is 1.6% of the $Int 188,645 in the United States to treat the same diabetic foot ulcer [41,42].…”

“…We previously estimated the expenses to both the patient and society of treating foot ulcers in five countries with widely varying health care practices, reimbursement policies, and gross domestic products [41,42]. It was estimated that in Tanzania the cost to the patient and relatives about $ 3,060 (International $: $Int), which is 1.6% of the $Int 188,645 in the United States to treat the same diabetic foot ulcer [41,42]. However, in African countries, medical insurance or reimbursement of medical expenses are not widely available, and therefore the management of a foot ulcer can cost 2 years of average income for the patient as seen in the case of Tanzania.…”

“…The risk of mortality at ten years for people with diabetic foot ulcer (DFU) is twice as compare to those who has not had DFU [40]. Foot complications, especially serious ones like the septic limb, can be serious and costly [1][2][3][33][34][35][36]41,42]. Most published reports confirm that foot lesions in SSA diabetic patients are associated with diabetic peripheral neuropathy (DPN), commonly have an infectious aetiology, and can be critical and costly [1][2][3]41,42].…”

“…The African continent is developing very fast and with increasing affluence due to urbanisation. At the same time, the literature is reporting increased rates of PAD in people with diabetes in past two decades, which can be dangerous and economically not viable [1][2][3]12,17,18,25,41,42]. Amputations are expensive and are devastating for the people with diabetes and their families, leading to loss of independency and livelihood [1][2][3]41,42].…”

“…At the same time, the literature is reporting increased rates of PAD in people with diabetes in past two decades, which can be dangerous and economically not viable [1][2][3]12,17,18,25,41,42]. Amputations are expensive and are devastating for the people with diabetes and their families, leading to loss of independency and livelihood [1][2][3]41,42]. Complications of lower limb are associated with high rates of morbidity and mortality [1][2][3].…”