Poor diabetics at greater risk of limb amputation

Diabetics in low-income neighbourhoods are up to 10 times more likely to lose a limb than patients residing in affluent areas, says a study.

"When you have diabetes, where you live directly relates to whether you will lose a limb to the disease," said lead author Carl Stevens, a clinical professor of medicine from David Geffen School of Medicine at University of California, Los Angeles (UCLA).

To reach this conclusion, researchers used data from the UCLA Center for Health Policy Research's California Health Interview Survey.

It estimated the prevalence of diabetes among low-income populations by ZIP code.

The result was a detailed set of maps showing diabetic amputation rates by neighbourhood for patients 45 and older - the age range at greatest risk for amputation from disease complications.

"Neighbourhoods with high amputation rates clustered geographically into hot spots with a greater concentration of households falling below the federal poverty level," said co-author Dylan Roby, director of health economics at UCLA.

Amputation patients were most likely to be black or non-English speaking, male, and older than 65.

People with poorly managed diabetes often suffer from a compromised immune system.

As a result, a blister or other foot injury may rapidly progress to a serious, even life-threatening infection.

Earlier diagnosis and proper treatment could prevent many of these amputations, researchers noted.

The findings, published in the journal Health Affairs, will motivate health providers to reach out to patients at risk of late intervention and inspire policymakers to adopt legislation to reduce barriers to care, researchers concluded.