Diabetes foot disease: the Cinderella of Australian diabetes management?

Table 1 Comparison of specific adult diabetes complication rates, hospitalisations, deaths and burden of disease in Australia

	High-risk^a		Acute complications			Hospitalisation		Burden of disease
	Population*	Service**	History - population^b*	History – service^c**[25]	New –Service^c**[25]	Admissions^d[6]	ALOS^d[6]	Deaths^d[6]	Burden Dx^e(DALY)^f[6]
CVD	21% [31]	40% [32]	NA	14.0%	4.3%	93,110	NA	7,617	74,687
Kidney	16% [30]	28% [25]	0.3% [30]	1.5%	0.3%	102,000	9	1,557	2,483
Eyes	15% [28]	29% [25]	2.1% [28]	0.9%	0.7%	38,700	NA	NA	1,258
Foot	20% [27]	25% [25]	2.1% [27]	1.5%	0.6%	59,240	12-26	1,705	18,544

ALOS: average length of stay; CVD: cardiovascular disease; DALY: disability adjusted life years; NA: not available.
*Population: Figures are taken from a population based study.
**Service: Figures are taken from a service-based study.
^a High Risk: CVD (coronary heart disease, cerebrovascular disease, peripheral vascular disease), Kidney (chronic kidney disease stage 3, eGFR < 60 ml/min per 1.73 m²), Eyes (retinopathy), Foot (peripheral neuropathy, peripheral arterial disease).
^b Acute Complication History – Population based: Kidney (chronic kidney disease stage 4 & 5, eGFR < 30 ml/min per 1.73 m²), Eyes (proliferative diabetes retinopathy), Foot (foot ulcer).
^c Acute Complication History – Service based: CVD (myocardial infarct, cerebral stroke), Kidney (end stage renal disease, eGFR < 30 ml/min per 1.73 m²), Eyes (blindness), Foot (lower limb amputation).
^d Hospitalisation: CVD (coronary heart disease, stroke), Kidney (chronic kidney failure), Eyes (retinopathy, glaucoma, cataract), Foot (peripheral neuropathy, peripheral vascular disease, foot ulcer, lower limb amputation).
^e Burden of disease: CVD (ischaemic heart disease, stroke), Kidney (renal failure), Eyes (retinopathy), Foot (peripheral neuropathy, peripheral vascular disease, foot ulcer, lower limb amputation).
^f DALY: Healthy life years lost in terms of illness, injury and premature death. DALY combines years of life lost to premature death and years of healthy life lost due to non-fatal health outcomes.

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