Medical researchers claim the incidence of diabetic foot infections have fallen by 50 percent over the last 15 years, but are Americans really becoming healthier, or are the statistics simply being manipulated?
Back in 2006, diabetic foot infections occurred in an average of 2.3 out of 100 individuals discharged with diabetes-related conditions. In 2010, that number sits at 1.1 percent, according to Bryson Duhon, a clinical assistant professor of pharmacy at the University of Texas at Austin. He added that the number of limb amputations from diabetic limb infections dropped from 35 percent to 21.6 percent over the 15-year span.
But Duhon isn’t quick to take the data at face level. In fact, he claims that the drop is simply due to a manipulation of the statistics. First, Duhon claims that a new characterization of the disease has impacted the numbers. In 1997, the diabetic criteria for fasting blood glucose dropped from 140mg/dL to 126 mg/dL, which meant millions more Americans were now categorized as diabetic. Also, these diabetics were some of the healthiest and least likely to succumb to a diabetic foot infection, which is often a late-stage complication of the disease.
“Although encouraging, the primary decrease in incidence was likely a result in newly diagnosed diabetes,” Duhon explained. “With less stringent criteria for the diagnosis of diabetes over the years, more patients are diagnosed with new and less severe diabetes as in the past. Thus these patients are less likely to experience the severe complications of diabetes such as diabetic foot infections.”
Duhon said the true diabetes statistics have remained rather static over the last 15 years.
“You are getting the same number of foot infections — but you are getting more diabetes diagnoses,” Duhon said. “So, to be honest, there really isn’t a reduction in these infections. We aren’t doing a better drop of preventing these infections or treating them.”
The New England Journal of Medicine reported similar findings, claiming the widened diagnostic criteria primarily caused the reduction in infection rates.
Dr. Silverman comments
Don’t like the percent of people having the disease? Don’t get better at treating it, just raise the denominator and lower the incidence in the population of people with the disease!
These findings only perpetuate the notion that statistics don’t lie, statisticians do.
