While it is generally understood within the healthcare environment that the prevalence of diabetes and peripheral vascular disease (PVD) are on the rise, the correlating assumption that this is leading to ever-increasing numbers of lower-limb amputations does not appear to hold true. Aggressive screening and improved management strategies for patients with diabetes and PVD have actually resulted in a decline in lower-limb amputations within these populations. However, the rate of this decline appears to be variable. This article reviews the temporal trends in amputation rates in patients with diabetes along with the effects of geographic variation, associated comorbidities, and race.
