The Economic Burden of Diabetic Foot and Ankle Disorders

Abstract

Physicians specializing in the care of patients with lower extremity disorders are acutely aware of the many adverse effects of diabetes mellitus and its secondary complications on all body systems. However, the disease has a devastating socioeconomic impact, as well. An estimated $98 billion in direct and indirect medical costs was spent on diabetes in 1997 in the United States. With a growing older population, cases of diabetes mellitus will certainly increase. The economic impact and clinical effectiveness of patient evaluation, preventive strategies, and treatment options are discussed.

Diabetes Cost Model of a Hospital in Thailand

“…Studies in India showed that the treatment expenditure of diabetic patients with foot complications was significantly higher than those without the complications [43,44]. Similarly, many studies showed that diabetic patients with diabetic foot ulcer had significantly higher health‐care costs [40,45–49]. Costs due to the complications attribute to the largest fraction of diabetic care [50].…”

Autologous G-CSF-Mobilized Peripheral Blood CD34+ Cell Therapy for Diabetic Patients with Chronic Nonhealing Ulcer

“…In addition, 5-year mortality rates after lower extremity amputation for diabetics, critical limb ischemia, and peripheral artery disease range from 39% to 68% (15). Furthermore, the economic burden of diabetic foot ulcer is estimated to be $98 billion per year (26). These data suggest the importance and necessity of alternative and more effective treatment option for diabetic patients with nonhealing ulcers.…”

Evaluation of Peripheral Neuropathy of Unknown Origin in an Outpatient Foot and Ankle Practice

“…Other aspects of care have been investigated by multiple authors, including psychological response of patients with diabetic foot ulceration, infection and amputation, and associated health care costs. 3,4,16,17,21,22 We assume that the same strategies used to manage the diabetic patient with neuropathy will be beneficial to the patient with idiopathic neuropathy or neuropathy related to other causes. In our practice, we routinely used the same protocols for diabetic neuropathy, including prolonged periods of immobilization and nonweightbearing, total contact casting, and surgical technique based on augmented fixation techniques in all neuropathic patients.…”