Decreasing amputation rates in patients with diabetes—a population-based study

Authors: Schofield, C. J.; Yu, N.; Jain, A. S.; Leese, G. P.

Source: Diabetic Medicine, Volume 26, Number 8, August 2009 , pp. 773-777(5)

Publisher: Wiley-Blackwell

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Abstract:

Aims

To assess the changing rate of amputation in patients with diabetes over a 7-year period. Methods

All patients undergoing lower extremity amputation in Tayside, Scotland between 1 January 2000 and 31 December 2006 were identified. Temporal linkage of cases to the diabetes database was used to ascertain which amputations were in patients with diabetes. Results

The incidence of major amputations fell from 5.1 [95% confidence interval (CI) 3.8-6.4] to 2.9 (95% CI 1.9-3.8) per 1000 patients with diabetes (P < 0.05). There is a clear linear trend in the adjusted incidence of major amputation (P = 0.023 and 0.027 for age- and sex-adjusted, and duration- and sex-adjusted incidences, respectively). The adjusted incidence of total amputations followed decreased linear regression trend over the whole study period when adjusted for age and sex or diabetes duration and sex (P = 0.002). Conclusions

There has been a significant reduction in the incidence of major lower extremity amputation in patients with diabetes over the 7-year period.

Keywords: Complications; amputation; diabetic foot; neuropathy; vascular disease

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1464-5491.2009.02770.x

Affiliations: 1: Dundee Epidemiology and Biostatistics Unit, Clinical and Population Sciences and Education, University of Dundee, Dundee, UK

Publication date: 2009-08-01