{"id":"https://openalex.org/W7225659407","doi":"https://doi.org/10.21203/rs.3.rs-11641383/v1","title":"Diabetic foot ulceration and diabetes-related lower-limb amputation in the Caribbean: burden, outcomes and care pathways \u2013 a scoping review","display_name":"Diabetic foot ulceration and diabetes-related lower-limb amputation in the Caribbean: burden, outcomes and care pathways \u2013 a scoping review","publication_year":2026,"publication_date":"2026-11-09","ids":{"openalex":"https://openalex.org/W7225659407","doi":"https://doi.org/10.21203/rs.3.rs-11641383/v1"},"language":"en","primary_location":{"id":"doi:10.21203/rs.3.rs-11641383/v1","doi":"https://doi.org/10.21203/rs.3.rs-11641383/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11641383/v1","pdf_url":"https://www.researchsquare.com/article/rs-11641383/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.researchsquare.com/article/rs-11641383/latest.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5161315026","display_name":"Emmanuel Benjamen","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I133879957","display_name":"St. George's University","ror":"https://ror.org/01m1s6313","country_code":"GD","type":"education","lineage":["https://openalex.org/I133879957"]}],"countries":["GD"],"is_corresponding":false,"raw_author_name":"Emmanuel Benjamen","raw_affiliation_strings":["St. George's University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"St. George's University","institution_ids":["https://openalex.org/I133879957"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5094151399","display_name":"Tanveer Randhawa","orcid":"https://orcid.org/0009-0006-4444-4000","observed_orcids":["https://orcid.org/0009-0006-4444-4000"]},"institutions":[{"id":"https://openalex.org/I133879957","display_name":"St. George's University","ror":"https://ror.org/01m1s6313","country_code":"GD","type":"education","lineage":["https://openalex.org/I133879957"]}],"countries":["GD"],"is_corresponding":false,"raw_author_name":"Tanveer Randhawa","raw_affiliation_strings":["St. George's University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"St. George's University","institution_ids":["https://openalex.org/I133879957"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161341225","display_name":"David Shamana","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I133879957","display_name":"St. George's University","ror":"https://ror.org/01m1s6313","country_code":"GD","type":"education","lineage":["https://openalex.org/I133879957"]}],"countries":["GD"],"is_corresponding":false,"raw_author_name":"David Shamana","raw_affiliation_strings":["St. George's University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"St. George's University","institution_ids":["https://openalex.org/I133879957"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5152432955","display_name":"Adan Ahmed","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I133879957","display_name":"St. George's University","ror":"https://ror.org/01m1s6313","country_code":"GD","type":"education","lineage":["https://openalex.org/I133879957"]}],"countries":["GD"],"is_corresponding":false,"raw_author_name":"Adan Ahmed","raw_affiliation_strings":["St. George's University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"St. George's University","institution_ids":["https://openalex.org/I133879957"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I133879957"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11227","display_name":"Diabetic Foot Ulcer Assessment and Management","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11227","display_name":"Diabetic Foot Ulcer Assessment and Management","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10926","display_name":"Peripheral Artery Disease Management","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12433","display_name":"Skin Diseases and Diabetes","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2708","display_name":"Dermatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/caribbean","display_name":"Caribbean","score":0.8259999752044678},{"id":"https://openalex.org/keywords/amputation-incidence","display_name":"amputation incidence","score":0.7009999752044678},{"id":"https://openalex.org/keywords/amputation-mortality","display_name":"amputation mortality","score":0.7590000033378601},{"id":"https://openalex.org/keywords/prostheses","display_name":"prosthesis","score":0.6110000014305115},{"id":"https://openalex.org/keywords/multidisciplinary-foot-care","display_name":"multidisciplinary foot care","score":0.7870000004768372},{"id":"https://openalex.org/keywords/diabetes-care-pathway","display_name":"diabetes care pathway","score":0.44699999690055847},{"id":"https://openalex.org/keywords/health-care-gaps","display_name":"health service gaps","score":0.47600001096725464},{"id":"https://openalex.org/keywords/barbados","display_name":"Barbados","score":0.7570000290870667},{"id":"https://openalex.org/keywords/trinidad-and-tobago","display_name":"Trinidad and Tobago","score":0.984000027179718},{"id":"https://openalex.org/keywords/martinique","display_name":"Martinique","score":0.9850000143051147},{"id":"https://openalex.org/keywords/research-gap","display_name":"research gaps","score":0.42100000381469727},{"id":"https://openalex.org/keywords/national-registry","display_name":"national registry","score":0.5569999814033508}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.914900004863739},{"id":"https://openalex.org/C2776204877","wikidata":"https://www.wikidata.org/wiki/Q477415","display_name":"Amputation","level":2,"score":0.8806999921798706},{"id":"https://openalex.org/C2777858829","wikidata":"https://www.wikidata.org/wiki/Q52856","display_name":"Diabetic foot","level":3,"score":0.7555000185966492},{"id":"https://openalex.org/C555293320","wikidata":"https://www.wikidata.org/wiki/Q12206","display_name":"Diabetes mellitus","level":2,"score":0.5771999955177307},{"id":"https://openalex.org/C2776135927","wikidata":"https://www.wikidata.org/wiki/Q5242559","display_name":"Referral","level":2,"score":0.5656999945640564},{"id":"https://openalex.org/C2909528719","wikidata":"https://www.wikidata.org/wiki/Q17054","display_name":"Martinique","level":3,"score":0.5494999885559082},{"id":"https://openalex.org/C61511704","wikidata":"https://www.wikidata.org/wiki/Q1671857","display_name":"Incidence (geometry)","level":2,"score":0.5209000110626221},{"id":"https://openalex.org/C115076146","wikidata":"https://www.wikidata.org/wiki/Q1651051","display_name":"Foot (prosody)","level":2,"score":0.4277999997138977},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.3635999858379364},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3601999878883362},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.3513999879360199},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.32499998807907104},{"id":"https://openalex.org/C2778144972","wikidata":"https://www.wikidata.org/wiki/Q52859","display_name":"Diabetic foot ulcer","level":4,"score":0.31450000405311584},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.28209999203681946},{"id":"https://openalex.org/C61434518","wikidata":"https://www.wikidata.org/wiki/Q932510","display_name":"General surgery","level":1,"score":0.27489998936653137},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.27399998903274536},{"id":"https://openalex.org/C2994302464","wikidata":"https://www.wikidata.org/wiki/Q1774706","display_name":"Care pathway","level":3,"score":0.2621999979019165},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.2551000118255615}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.21203/rs.3.rs-11641383/v1","doi":"https://doi.org/10.21203/rs.3.rs-11641383/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11641383/v1","pdf_url":"https://www.researchsquare.com/article/rs-11641383/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.21203/rs.3.rs-11641383/v1","doi":"https://doi.org/10.21203/rs.3.rs-11641383/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11641383/v1","pdf_url":"https://www.researchsquare.com/article/rs-11641383/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/systematic-review","display_name":"Systematic Review"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225659407.pdf","grobid_xml":"https://content.openalex.org/works/W7225659407.grobid-xml"},"referenced_works_count":27,"referenced_works":["https://openalex.org/W2128915753","https://openalex.org/W2512791245","https://openalex.org/W2800318305","https://openalex.org/W2891378911","https://openalex.org/W2946406304","https://openalex.org/W3015983581","https://openalex.org/W3183655489","https://openalex.org/W3191573513","https://openalex.org/W3196078772","https://openalex.org/W4200039036","https://openalex.org/W4224309682","https://openalex.org/W4285742691","https://openalex.org/W4295048904","https://openalex.org/W4311978548","https://openalex.org/W4366588278","https://openalex.org/W4382918816","https://openalex.org/W4386877653","https://openalex.org/W4387241578","https://openalex.org/W4407707246","https://openalex.org/W4411410032","https://openalex.org/W4414313191","https://openalex.org/W7128501403","https://openalex.org/W7134034680","https://openalex.org/W7163769118","https://openalex.org/W7167036239","https://openalex.org/W7204276537","https://openalex.org/W7213241630"],"related_works":["https://openalex.org/W4399247136","https://openalex.org/W4295048904","https://openalex.org/W2253436132","https://openalex.org/W4281734463","https://openalex.org/W4312188510","https://openalex.org/W2803695465","https://openalex.org/W149810482","https://openalex.org/W2128915753","https://openalex.org/W1863255290","https://openalex.org/W3007481061"],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Diabetic":[2],"foot":[3,59,202,256,265,291,345],"ulceration":[4,60,292],"and":[5,23,34,36,54,61,66,73,101,123,125,142,145,166,183,185,236,244,261,274,278,293,301,330,334,338,343],"diabetes-related":[6],"lower-limb":[7],"amputation":[8,62,100,207,294],"are":[9],"late":[10],"complications":[11],"of":[12,16,57,198,224,246,317,340],"diabetes,":[13],"the":[14,27,51,64,83,112,158,167,222,238,324],"frequency":[15],"which":[17],"depends":[18],"on":[19,50,289],"early":[20],"detection,":[21],"referral":[22],"treatment.":[24],"Evidence":[25],"from":[26,47,111,116,228],"Caribbean":[28,65,102,287],"is":[29,295],"scattered":[30],"across":[31],"single":[32],"countries":[33,260],"institutions":[35],"has":[37],"not":[38],"been":[39],"mapped.":[40],"We":[41,77,306],"aimed":[42],"to":[43,67,71,230],"map":[44],"evidence":[45,288],"published":[46],"2016":[48,117],"onward":[49,118],"burden,":[52],"outcomes":[53],"care":[55,346],"pathways":[56],"diabetic":[58,98,255,290],"in":[63,174,204,209,216,258,298],"identify":[68],"gaps":[69],"relevant":[70],"surveillance":[72],"health":[74],"services.":[75,347],"Methods":[76],"conducted":[78],"a":[79,107,139,192,201,249,327],"scoping":[80],"review":[81],"following":[82],"PRISMA-ScR":[84],"guidelines.":[85],"No":[86],"protocol":[87],"was":[88,91,211,242],"registered.":[89],"PubMed":[90],"searched":[92],"with":[93,128],"7":[94],"query":[95],"blocks":[96],"combining":[97],"foot,":[99],"place":[103],"names,":[104],"followed":[105],"by":[106,121],"supplementary":[108,168],"search":[109,149,169],"seeded":[110],"included":[113,176],"studies.":[114,190],"Records":[115],"were":[119,132,136],"screened":[120],"title":[122],"abstract,":[124],"only":[126],"studies":[127,156,177],"accessible":[129,163],"full":[130,164],"texts":[131],"included.":[133],"The":[134,148,206,267],"data":[135],"extracted":[137],"into":[138],"44-field":[140],"worksheet":[141],"synthesized":[143],"descriptively":[144],"thematically.":[146],"Results":[147],"identified":[150],"150":[151],"records":[152],"(94":[153],"unique).":[154],"Twenty-one":[155],"passed":[157],"abstract":[159],"screening,":[160,341],"15":[161],"had":[162,200],"texts,":[165],"added":[170],"2":[171,299],"studies,":[172,312],"resulting":[173],"17":[175],"(7":[178],"core,":[179],"10":[180],"partial).":[181],"Barbados":[182,193],"Trinidad":[184,220],"Tobago":[186],"each":[187],"contributed":[188],"5":[189],"In":[191],"diabetes":[194],"programme,":[195],"14.7%":[196],"(33/225)":[197],"patients":[199,247],"ulcer":[203,310],"2019.":[205],"incidence":[208,311],"Martinique":[210],"48.9":[212],"per":[213,232],"100,000":[214],"inhabitants":[215],"2018.":[217],"At":[218],"one":[219],"institution,":[221],"number":[223],"major":[225],"amputations":[226],"increased":[227],"66":[229],"152":[231],"year":[233],"between":[234],"2010":[235],"2016,":[237],"2-year":[239],"mortality":[240],"rate":[241],"34%,":[243],"14.5%":[245],"acquired":[248],"prosthesis.":[250],"A":[251],"25-country":[252],"survey":[253],"revealed":[254],"guidelines":[257],"9":[259],"no":[262,308],"functional":[263],"multidisciplinary":[264,320],"units.":[266],"authors":[268],"most":[269],"often":[270],"reported":[271],"sample":[272],"size":[273],"representativeness":[275],"(10/14":[276],"studies)":[277],"selection":[279],"or":[280,304,315,319],"self-report":[281],"bias":[282],"(9/14)":[283],"as":[284],"limitations.":[285],"Conclusions":[286],"limited,":[296],"concentrated":[297],"countries,":[300],"largely":[302],"single-center":[303],"cross-sectional.":[305],"found":[307],"population-based":[309,336],"national":[313],"registries,":[314],"evaluations":[316,339],"prevention":[318],"programs.":[321],"Priorities":[322],"for":[323,332],"region":[325],"include":[326],"shared":[328],"definition":[329],"registry":[331],"ulcers":[333],"amputations;":[335],"estimates;":[337],"education":[342],"organized":[344]},"counts_by_year":[],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-11-10T00:00:00"}