Introduction, demographics, and epidemiology of diabetes

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The Surgical Management of the Diabetic Foot and Ankle


Diabetes mellitus, a leading cause of mortality, is a complex condition caused by uncontrolled hyperglycemia. A diabetes diagnosis increases the risk of developing additional comorbidities, including cardiovascular disease, nephropathy, retinopathy, mental health disorders, and neuropathies. The rate of new diabetes diagnoses in the United States has not significantly changed since 2006, according to the Centers for Disease Control and Prevention; however, the International Diabetes Federation (IDF) estimates that prevalence of diabetes will increase by 53 % worldwide between 2014 and 2035, growing from approximately 387 million people to 592 million affected. Africa, Middle East/North Africa, and South East Asia will be most impacted by 2035, with estimated increases of 93 %, 85 %, and 64 % people affected by diabetes in each region, respectively. While the international cost of diabetes was $612 billion of all healthcare expenses by health systems and patients in 2014, the IDF expects this figure to increase to approximately $627 billion by 2035. Epidemiological studies have analyzed the diabetic population demographically, to assess factors such as age, sex, race/ethnicity, socioeconomic status, and environment in diabetes development. Although the polymorphisms of the disease, Type I diabetes and Type II diabetes, are commonly known, many variants of diabetes exist. Numerous etiologies of diabetes, such as infection, chemical exposure, and genetic defects, have been identified, although some causes remain unknown. Epigenetic-, gene-, and genome-wide association-based studies have continued to investigate multifactorial linkages between the human genome and development of diabetes.

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