Diabetic foot syndrome
Diabetes can lead to the development of diabetic foot syndrome. Risk factors include polyneuropathy, occlusive peripheral arterial disease or a combination of both. These can lead to injuries and/or wounds on the feet that go unnoticed and which are characteristic of diabetic foot syndrome (BÄK et al., 2006). Amputation may be necessary if conservative treatment of infection is insufficient.
Key messages
- 6.2% of adults with diabetes have a documented diabetic foot syndrome.
- Since 2011, it has been mandatory for doctors to document diabetic foot syndrome when prescribing podiatric treatments which may have contributed to an increase in documentation.
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Results
In 2013, 6.2% of adults with diabetes had documented diabetic foot syndrome (women: 5.7%; men: 6.6%). This figure increases with age and peaks at 7.3% in the 80-plus age group (women: 7.0%; men: 7.9%).
Conclusion
As is the case with diabetic polyneuropathy, varying documentation and diagnosis standards make it difficult to compare data sources. DMP data on type 2 diabetes in North Rhine-Westphalia put the proportion of patients with diabetic foot syndrome slightly higher. Once again, variance is most apparent in the older age groups (Zi, 2019). Other studies report prevalences of between 2% and 10% (Sämann et al., 2008, Bohn et al., 2018, Böhler et al., 2006). Since 2011, it has been mandatory for doctors to document diabetic foot syndrome when prescribing podiatric treatments (GKV Spitzenverband, 2011). This may have contributed to an increase in documentation, a trend which can also be observed from DMP data (Hagen et al., 2010-2017).
Show more information on methodology and data sources
Definition
The indicator Diabetic foot syndrome is defined as the proportion of persons with diabetes with documented diabetic foot syndrome (E10.74-14.74 / E10.75-14.75).
Reference population
Adults are included in the analysis if they have statutory health insurance and documented diabetes (in accordance with the definition of the Prevalence of documented diabetes indicator), have been insured for at least 360 days in the respective year, reside in Germany and have their health benefits fully reimbursed by the statutory health insurance.
Data source
Claims data from approximately all of the 70 million people with statutory health insurance collected in accordance with the Data Transparency Ordinance (DaTraV data). Around 55 million are at least 18 years old, of which around 6.6 million have documented diabetes.
Calculation
- Observed relative values: The quotient of the number of people with documented diabetes and documented diabetic foot syndrome in relation to the population with statutory health insurance and documented diabetes.
- Observed absolute values: Number of persons covered by statutory health insurance with documented diabetes and documented diabetes foot syndrome.
- Age standardisation: Direct age standardisation used 18- to 24-year-olds as one age group, five-year age groups for the ages 25 to 29 until 80 to 84, and then a separate group for the ages 85 and over. The DaTraV population with documented diabetes in 2013 was used as the reference population.
Data quality
DaTraV data are claims data on all people covered by SHI. DaTraV data include documented outpatient and inpatient diagnoses as well as information on prescribed medications. The quality of claims data from SHI depends on conduct of documentation. DaTraV data do not cover people insured by private health insurance and do not provide information on inpatient or outpatient care.