Diabetes-related amputations fall significantly since 1990s

Researchers said double-digit decreases in two of three types of common diabetes-related amputation emphasize improvements in care made in the last two decades.

By Stephen Feller

ODENSE, Denmark, Nov. 23 (UPI) -- Improvement of diabetes treatment has led to a significant decrease in amputations related to the disease, according to a study of medical records in Denmark.

Nerve and blood vessel damage are among the long-term effects of the disease, and often lead to poor circulation in the lower limbs and feet. The circulation can be so bad that hospitalization and amputation are necessary.


Better care of diabetes patients -- specifically improved drugs, and inspection and self-care of foot ulcers related to the disease -- has led to the decrease in poorer conditions that lead to amputation.

"The introduction of vascular surgery and improved surgical techniques cannot explain our findings, since these procedures are applied equally in individuals with and without diabetes," researchers wrote in the study, published in Diabetologia. "The findings in individuals with diabetes can therefore only be explained by improved diabetes care, namely improved metabolic control through drugs or lifestyle, or changes in how care is delivered, including better screening -- we believe it to be both."

Researchers at Odense University Hospital in Denmark analyzed health records collected between 1996 and 2011 in the County of Funen, home to about half a million people, from the hospital administration system, Danish National Diabetes Register and Statistics Denmark.


During the 15-year period, the researchers found a total of 2,832 amputations performed -- 1,285 on patients with diabetes and 1,547 among those without diabetes.

Diabetes patients had 11 times the risk of below-ankle amputations, 7 times the risk for from-ankle-to-knee amputations, and 4 times the risk of needing above-knee amputations, but the the rate of each type of amputation fell by 10 percent, 15 percent, and 3 percent during the study period, researchers reported.

"The reduction of amputations among diabetics is encouraging. The results presented here indicate that multidisciplinary diabetic clinics optimized for screening and treating complications linked to diabetes are beneficial," the researchers wrote. "It is encouraging that the overall amputation rate is declining in most parts of the world. However, amputation rates in patients with diabetes remain high compared to individuals without diabetes posing a great challenge to improve care."

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