A new bibliometric study published in the International Journal of Environmental Research and Public Health offers the most comprehensive look yet at the evolution of diabetic foot research over the past 20 years . By analyzing more than 7,100 publications indexed in Scopus between 2004 and 2023, the authors reveal how scientific production has expanded, who is leading the field, and where research is heading.
The results underscore both the challenges and the momentum in preventing amputations and improving outcomes for people with diabetes.
📈 A Field in Full Growth
- Scientific output multiplied 6.6-fold from 2004 to 2023, with an annual growth rate of more than 10% .
- Over 145,000 citations were recorded, reflecting the influence of this body of work.
- Nearly 24,000 authors contributed, representing 114 countries—a truly global effort .
🏆 The Top Ten Highlights
1. Most Productive Author
- David G. Armstrong (USC, USA) leads the world with 160 publications and over 13,000 citations, holding the highest local h-index .
2. Leading Collaborators
- Other highly productive authors include Benjamin A. Lipsky (UK), José Luis Lázaro-Martínez (Spain), Lawrence A. Lavery (USA), and Andrew J.M. Boulton (USA)—together shaping much of the modern knowledge base .
3. Country Productivity
- China is the most productive country, with 6,488 papers (18.4% of the total).
- United States follows with 4,645 publications, but leads in citations (28.6% of the global total).
- United Kingdom, India, and Italy round out the top five .
4. Most Cited Countries
- The United States dominates with more than 37,000 citations.
- The Netherlands shines in impact, averaging 54 citations per paper—the highest among all nations .
5. Core Journals
- The International Journal of Lower Extremity Wounds is the most prolific (278 publications).
- The International Wound Journal and Journal of Wound Care are also central outlets.
- Diabetes Care ranks as the most cited, with nearly 9,000 citations .
6. Landmark Articles
Among the Top 10 most cited papers, several stand out:
- NEJM (2017): Armstrong, Boulton, and Bus on diabetic foot ulcer recurrence (2,245 citations).
- Lancet (2005): Boulton et al. on the global burden of diabetic foot disease (1,854 citations).
- CID (2012): Lipsky et al. on guidelines for diabetic foot infection management (1,348 citations) .
7. Foundational References
The most cited reference overall?
- Singh, Armstrong & Lipsky (JAMA, 2005) on preventing foot ulcers in patients with diabetes, with 553 citations .
8. Hot Topics
- Consistently recurring keywords: amputation, wound healing, infection, osteomyelitis.
- Emerging and niche themes: antibiotic resistance, deep learning, machine learning, artificial intelligence .
9. Collaboration Networks
- The strongest research collaborations exist between the United States and the United Kingdom, and across the European Union.
- China leads in volume but still has relatively less international collaboration .
10. Thematic Evolution
- In the early 2000s, research emphasized ulcer classification and wound care.
- The last decade has seen an expansion toward prevention, multidisciplinary care, AI-driven diagnostics, and regenerative therapies .
🌍 Why This Matters
This bibliometric map tells a story of progress: diabetic foot research has not only grown in scale, but also in sophistication and diversity. The integration of artificial intelligence, advanced wound care technologies, and global collaborations suggests a future where preventable amputations can truly become a thing of the past.
The study also highlights that despite progress, the field remains in expansion, with many “occasional authors” contributing. This reflects the multidisciplinary nature of diabetic foot care—and the importance of building enduring networks of expertise.
📖 Citation:
Fuentes-Peñaranda Y, Labarta-González-Vallarino A, Arroyo-Bello E, Gómez de Quero Córdoba M. Global Trends in Diabetic Foot Research (2004–2023): A Bibliometric Study Based on the Scopus Database. Int J Environ Res Public Health. 2025;22(463). https://doi.org/10.3390/ijerph22040463
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