• Diabetic foot ulcer is a common condition in diabetic patients and is a key health concern worldwide. Diabetic foot ulcers are thickened wounds below the ankle. It is caused by irritated or wounded feet due to minor trauma or pressure, neuropathic and vascular changes, poor circulation, and high blood sugar. Healing of wounds is typically an innate mechanism of our body but, certain metabolic disorders such as diabetes mellitus delays the typical pace of the wound healing process. Swelling, redness, irritation, and stenches are common initial symptoms of foot ulcers. It is a disabling disorder, which is highly prone to infection and might lead to amputation of the leg. Diabetic foot ulcer treatments, usually include control of blood sugar, removal of dead tissue, wound dressings, and negative pressure therapy. The treatment is divided into five stages, stage 1, which is a normal foot; stage 2, high-risk foot; stage 3, an ulcerated foot; stage 4, an infected foot; and stage 5, a necrotic foot. It is important to prevent the development of diabetic foot ulcers in stage 1 and 2 while stage 3 require urgent treatment.
• Mortality due to diabetic foot ulcers is high and there are huge chances of recurrence of cured foot ulcers. According to the National Institutes of Health (NIH), diabetic foot ulcers are responsible for more than 80% of all diabetes-related lower-leg amputations and occur in around 15% of diabetic patients. As per the World Health Organization (WHO), the number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014.
Market Dynamics
• The major drivers fueling the growth of the market are the rising prevalence of chronic diabetes, rapidly growing geriatric population worldwide and advancements in the field of research.
• According to an article by Bakker et al, it is estimated that around 15% of all people with diabetes are affected by foot ulcers during their lifetime and 1 in 4 people with diabetes develop at least one ulcer. For every 30 seconds, one leg is amputated due to diabetes. This is mainly because people affected with diabetes are prone to bruises and ulcers caused on feet and even other parts.
• Centre for Disease Control and Prevention (CDC) in 2018 estimated that around 20% of the hospitalizations among diabetic patients is due to foot ulcers out of which 72% of individuals are above the age of 60. This has resulted in alarming hospitalization rates as old-aged people are highly prone to developing pressure-based ulcers and bruises. With rising awareness among the masses to treat these maladies, higher demand for relevant medications is rising.
Market Restraints
• The high cost of ulcer management, lack of healthcare facilities, high costs of research and development and huge competition among major companies are going to restrain the market in the forecast period.
• According to CDC, an average of 9 to 12 days of hospitalization is required for a diabetic patient after a lower limb amputation. This raises the cost of treatment. The annual cost for treating diabetic foot ulcers is increased considerably in the past few years.
• The market can be segmented by product type as Wound Care Dressings, Biologics, and others. Wound Care Dressings is further classified as Foam Dressing, Hydrocolloid Dressing, Hydrogel Dressing, Alginate Dressing and Others Dressing, Biologics is further segmented as Growth Factors and Skin Graft and Skin Substitutes. By ulcer type, the market is segmented as Neuropathic Ulcers and Neuro-Ischemic Ulcers and by end-user as Hospital, Clinics, Ambulatory Surgical Centers and Homecare Setting.
• Dressing is the most widely used treatment for diabetic foot care. The management of diabetic foot ulcers is carried by various wound care dressings procedures including foam dressing, hydrocolloid, hydrogel, alginate, and other dressings. Foam dressings are generally comprised of hydrophilic polyurethane foam that absorbs wound fluids, maintain moist around wound surface, and promotes healing. Based on the study conducted by SRM Medical College & Research Institute, polyurethane foam dressings shown convenient and effective results in treating diabetic foot ulcers.
• Neuropathy in diabetes patients causes due to the failure of blood vessels that supply oxygen and nutrients. According to CDC between 60% and 70% of the people with diabetes suffers from diabetic neuropathy annually, where the nerves of the feet and legs are mostly affected. Feet of diabetic patients are prone to neuropathy due to insufficient blood flow and unchecked blood sugar. Neuropathic ulcers are caused by repeated stress on feet that have reduced sensation resulting in renal failure and trauma.
• Geographically, the global diabetic foot ulcer market is divided into North America, Europe, South America, Asia-Pacific and the Middle East and Africa.
• North America held the largest share of the diabetic foot ulcer market owing to the rising prevalence of diseases, elevated patient awareness levels and growing acceptance for the products. US has the highest standards of health care. According to International Diabetes Federation (IDF), over 100 million of the adults in the US are suffering from prediabetes or diabetes and another 84.1 million have prediabetes conditions, which if not treated may lead to type 2 diabetes within five years. The total medical cost for the management of diabetic foot disease in the United States ranges from the US $ 9 to the US $ 13 billion in 2017.
• The Asia Pacific market is expected to have the highest growth rate over the period of forecast because of the growing population and increasing healthcare expenditure. According to Australian National Diabetes Information Audit & Benchmarking report in Australia, around 1.7% of the diabetic population in 2009 had diabetic foot ulcers which have increased to 2.1% by the end of 2011 and about 15% of diabetics have a foot ulcer in their lifetime.
• Some of the major market players are 3M Healthcare Ltd., Coloplast A/S, B.Braun, Smith & Nephew, ConvaTec Inc., Molnlycke Health Care, BSN Medical and Acelity.
• The top competitors in the global diabetic foot ulcers market are Smith and Nephew, B.Braun and 3M and they account for almost half of the market share. Other dominant players of the global diabetic foot ulcers market include Medtronic and ConvaTec. The companies are heavily investing in the market to develop new products and are collaborating and acquiring other companies which help in increasing their market share and strengthen R & D. The diabetic foot ulcers companies are offering a wide range of products, most of which are similar to other companies, which lead to price wars.
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