Diabetes-related foot disease (DFD) remains a major complication in people with diabetes, but reported incidence rates vary widely across populations. A large analysis published in Diabetes Research and Clinical Practice evaluated the incidence of DFD and its individual components using data from two major cohorts along with a systematic review and meta-analysis.

The analysis included individuals with diabetes who were free of DFD at baseline from the UK Biobank and the Chongqing Diabetes Registry (CDR). DFD was defined according to the International Working Group on the Diabetic Foot 2023 criteria. The study also integrated findings from 64 additional cohorts identified through a systematic review to estimate pooled incidence rates and assess variability across studies.

The incidence of DFD was 12.81 (95% confidence interval [CI], 12.46-13.15) per 1000 person-years in the UK Biobank and 24.97 (95% CI, 21.38–28.99) per 1000 person-years in the CDR cohort. Pooled estimates showed incidence rates of 19.84 (95% CI, 16.58-23.10) for peripheral neuropathy and 7.32 (95% CI, 6.17-8.47) for foot ulcer. Lower rates were observed for lower-extremity amputation at 2.56 (95% CI, 2.20-2.93), lower-extremity arterial disease at 2.56 (95% CI, 1.08-4.04), and gangrene at 0.81 (95% CI, 0.00-1.74) per 1000 person-years.

The analysis showed that DFD incidence exceeded 10 per 1000 person-years across cohorts. Peripheral neuropathy and foot ulcer accounted for a large proportion of cases. Marked variability across studies indicates that incidence estimates differ by population and setting.