Background
Among people with diabetes, chronic lower limb complications are common, making a significant contribution to the morbidity and mortality associated with the disease. The aim of this systematic review was to determine the prevalence of diabetes-related lower limb complications in Aboriginal and Torres Strait Islander people in Australia.
Methods
An electronic search of MEDLINE (from January 1966), EMBASE (from January 1980), Cochrane Central Register of Controlled Trials (CENTRAL)(The Cochrane Library 2015, Issue 2), PUBMED (from January 1966) and CINAHL (from 1982) for studies reporting the prevalence of any chronic lower limb complications in IA was conducted in August 2016. There were no language or publication restrictions. Two authors independently selected trials. One author extracted data, which was cross checked by a second author. Data are presented separately for different chronic lower limb complications.
Results
Eight studies published in 10 papers were included. Studies were conducted in Western Australia, Northern Territory and Queensland. Only one study was based in an urban setting. Overall, IA tended to experience more chronic lower limb complications at a younger age than non-IA. In the geographical regions studied, IA commonly accounted for the majority of complications despite comprising a relatively small proportion of the population. Notably, of individuals 25 to 49 years of age with diabetes, IA were 38 times more likely than non-IA to undergo major amputation and 27 times more likely than non-IA to undergo minor amputation.
Conclusion
IA experienced substantially more diabetes-related chronic lower limb problems at a younger age than non-IA and underwent markedly more amputations. There were no data available for some states and for many lower limb complications associated with significant morbidity and mortality in the general population.