{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T10:27:51Z","timestamp":1771324071502,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T00:00:00Z","timestamp":1766620800000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Foot and Ankle Research"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetic foot ulcers (DFUs) are a major complication of diabetes, leading to severe morbidity and high healthcare costs. Despite numerous studies on the prevalence of DFUs in Pakistan, the findings vary widely, making it difficult to obtain a clear estimate. To address this gap, we conducted a meta\u2010analysis to determine the overall prevalence of DFUs among diabetic patients in Pakistan, providing a more comprehensive understanding of the burden of this condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic search was conducted in PakMediNet, PubMed, Scopus, Web of Science, and Google Scholar without language or time restrictions. Two independent reviewers screened studies, extracted data, and assessed quality. Heterogeneity was evaluated using Cochran's Q and I\n                      <jats:sup>2<\/jats:sup>\n                      . Subgroup analysis, meta\u2010regression, and sensitivity analysis were performed. Publication bias was assessed via a funnel plot and Egger's test. The meta\u2010analysis was conducted using a random\u2010effects model in Stata 17.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In this meta\u2010analysis, 16 studies with a total of 15,333 participants were analyzed. The pooled prevalence of DFUs was estimated at 18%, with a prevalence of 19.4% in Punjab and 16.6% in other regions. The prevalence was reported as 20.8% in men and 14.9% in women. Sensitivity analysis indicated that the results were highly stable. Meta\u2010regression revealed a significant increasing trend in the prevalence of DFUs from 1999 to 2022. Although statistical tests confirmed the presence of publication bias, the trim\u2010and\u2010fill method suggested that its impact was negligible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This meta\u2010analysis provides a comprehensive estimate of the prevalence of DFUs, highlighting regional and gender differences. The findings show a significant increasing trend over time, emphasizing the growing burden of this condition. These results highlight the need for targeted prevention strategies and improved management of DFUs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jfa2.70117","type":"journal-article","created":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T23:15:17Z","timestamp":1766704517000},"source":"Crossref","is-referenced-by-count":0,"title":["Diabetic Foot Ulcers in Pakistan: A Silent Epidemic?\u2014A Meta\u2010Analysis of Observational Studies"],"prefix":"10.1002","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7414-8134","authenticated-orcid":false,"given":"Reza","family":"Ghanei Gheshlagh","sequence":"first","affiliation":[{"name":"Nursing Department, Faculty of Health Sciences Biruni University  Istanbul Turkey"},{"name":"Social Determinants of Health Research Center Research Institute for Health Development Kurdistan University of Medical Sciences  Sanandaj Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Esmaeelzadeh","sequence":"additional","affiliation":[{"name":"Student Research Committee Birjand University of Medical Sciences  Birjand Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kainat","family":"Asmat","sequence":"additional","affiliation":[{"name":"Shifa Tameer\u2010e\u2010Millat University (STMU)  Islamabad Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2288-695X","authenticated-orcid":false,"given":"Simin","family":"Sharafi","sequence":"additional","affiliation":[{"name":"Department of Nursing School of Nursing and Midwifery Birjand University of Medical Sciences  Birjand Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,25]]},"reference":[{"key":"e_1_2_14_2_1","first-page":"109","article-title":"Diabetic Foot Ulcer Grand Challenge 2024: Overview and Baseline Methods","volume":"7","author":"Br\u00fcngel R. 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