Diabetes care growth leads to major fall in amputations

There has been a significant reduction in diabetes-related amputations since the mid-1990s due to improvements in diabetes care over this period, according to a new research.

Amputations of the lower limbs are one of the most serious and disabling complications of diabetes, and become necessary when the nerve and blood vessel damage caused by the condition affects the blood supply to the lower limbs, especially the feet. Serious problems with the feet (including ulceration) are a frequent reason for hospitalisation amongst patients who have diabetes.

This new study analysed amputation rates in the Funen region of Denmark (with 0.5 million residents and regarded as representative of both the population of Denmark as a whole and other high-income countries of Europe and the world) during the period 1996-2011.

The researchers found an annual reduction in below-ankle amputation (BAA) rates among diabetes patients of 10 percent and the annual reduction in below-knee amputation (BKA) rates for patients with diabetes was 15 percent; for above-knee amputations (AKA), the annual rate of reduction for those with diabetes was around 3 percent but not statistically significant.

The authors believe that better care related to diabetes and its complications, such as improved drugs and inspection and self-care of foot ulcers (that can get worse until they require amputation), are the central cause of the reduced amputation rates.

To reduce the amputation rate further, the authors suggest a focus on establishing multidisciplinary diabetic clinics highly specialised in the diagnosis and treatment of the underlying macro- and microvascular diseases; diabetic foot ulcer clinics have an important role within these clinics.

The study appears in Diabetologia.