Diabetes in America

Approximately 9 million Americans suffer from chronic open wounds annually that can lead to the development of osteomyelitis and sometimes require amputation. The cost of care for diabetic and ischemic ulcers is extremely high. Nationwide, chronic wound care represents nearly $10 billion in health care costs.

Diabetes is a fast growing disease, currently affecting 3% of the population or 14 M in USA. In 1995, worldwide there were 130 M diabetics, 154 M by 2000 and anticipated to be 308 M by 2025. Diabetes is the leading cause of heart disease, nerve damage, stroke, blindness, skin ulcers, impotence and amputations. In the US, the treatment of diabetic complications accounts for 55% of the $100 billion disease management costs. Diabetic care is disproportionably expensive and a major drain on the burdened healthcare system. Diabetic elders consume 40% of skilled nursing days, 29% of home health visits, 26% of ER visits, and 21% of office consults. Diabetes is the cause of 25% of all Diabetic hospitalizations in US and UK, and 15% of the 14 M US Diabetics in a lifetime have ulcers.

The worst outcome of diabetic foot ulcers is amputation: fifty percent of all lower limb amputations (LEA) are diabetics: 54,000/year have 1 LEA and 28-51% have a second amputation within 5 years. Thus at five years, over half of the 54,000 (27,000) LEA's have a double amputation due to leg untreatable ulcers that remain as open and very painful wounds.

About 6% of hospitalized and discharged diabetics have foot ulcers, or about 840,000/year. Of these, 2.4% are chronic ulcers (20,580). 162,500 Diabetics are hospitalized for foot ulcers per year.
Diabetic foot ulcers typically cost $17,500 (HMOT) to treat and $33,000 to amputate.