Diabetes and Lower-Limb Amputations in the Community: A retrospective cohort study

Abstract

These population-based U.K. amputation data are similar to amputation rates in the U.S. Amputation rates appear to have decreased significantly since 1980-1982. The impact of diabetes education and prevention programs that target the processes leading to amputation can now be evaluated.

Lower limb amputations

“…However, they usually include only vascular and diabetic amputations and those due to trauma or tumors have been excluded (Luther et al 2000;Wrobel et al 2001;Morris et al 1998;Luther 1994;Feinglass et al 2000). Also, reports on gender differences are sparse and include only vascular and diabetic amputations.…”

“…The figures are not directly comparable because the number of diabetics in our region is unknown and incidences are calculated in the total population. Also, in studies by Feinglass et al (2000) and Morris et al (1998), traumatic and tumour amputations had been excluded. However, it seems to be that gender difference in the present population is even higher.…”

“…The underlying cause of amputation has been in 80 -95% vascular disease with or without diabetes (Wrobel et al 2001;Pohjalainen and Alaranta 1999;Morris et al 1998). During recent decades the treatment of chronic critical limb ischaemia became more active.…”

Sustained reduction in major amputations in diabetic patients: 628 amputations in 461 patients in a defined population over a 20-year period

“…Several reports from single centers, usually not population-based, have since reported a substantially reduced incidence of major lower extremity amputations in patients with diabetes mellitus following the implementation of various multidisciplinary programs for prevention and treatment of diabetic foot ulcers , Humphrey et al 1996, Schraer et al 1997, Rith-Najarian et al 1998, Calle-Pascual et al 2001, Holstein et al 2001). However, an unchanged or increased incidence of lower-limb amputations has been described by several other authors (Morris et al 1998, Stiegler et al 1998, Pohjolainen and Alaranta 1999, Trautner et al 2001. Doubts have been raised regarding the possibility of obtaining and maintaining such a reduction for more than a limited number of years (Trautner et al 1996, Jeffcoate and Harding 2003, Jeffcoate 2004, particularly in view of the ageing population and an increasing prevalence of diabetes (the Global Lower Extremity Amputation Study Group 2000, Zimmet et al 2001.…”

The Relationship Between Alcohol Consumption and Glycemic Control Among Patients with Diabetes: The Kaiser Permanente Northern California Diabetes Registry

“…1 Diabetes is a strong risk factor for cardiovascular disease and end stage renal disease, is the most common cause of blindness among working-age adults, and is responsible for half of non-traumatic lower extremity amputation in the United States. [1][2][3][4][5][6][7][8] In 2002, per capita medical expenditures for people with diabetes were $13,243, compared to $2,560 for persons without diabetes, and total direct medical expenditures exceeded $91 billion. 9 Glycemic control is a strong predictor of diabetes complications, particularly microvascular complications.…”