Trends in the rate of diabetes-related nontraumatic lower-limb amputation have sharply declined since 2000 among people aged 75 years and older, women, and white people. These findings were presented by Yanfeng Li, MPH, of the division of diabetes translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), at the American Diabetes Association (ADA) 70th Scientific Sessions, June 25-29, in Orlando, Florida.
Although follow-up data provided by researchers at the CDC reveal an increase in the total number of nontraumatic lower-limb amputation hospitalizations-54,738 in 1998 to 65,714 in 2006-the age-adjusted discharge rate showed a slight decline from 1998 (7.3 per 1,000) to 1997 (7 per 1,000), and decreased by 7.8 percent per year until 2006 (3.5 per 1,000; P<.01).
There was a similar pattern for people aged 74 years and younger, with declining rates in the mid-90s by about 7 percent per year (P<.01). For people aged 75 years and older, the researchers noted a steep decline starting in 2000, with an annual percentage change (APC) of 15.4 percent.
When the researchers examined trends by gender, men had higher amputation rates between 1988 and 2006 (P<.01). The age-adjusted rate for men started to decrease after 1996 by an APC of 8.1 percent; the age-adjusted rate for women started to decline after 2000 by an APC of 12.1 percent (P<.01 for both).
Further, black patients had a higher rate of amputations compared with white patients; the age-adjusted rate decreased throughout the study period for black people (APC: 3.2 percent), but decreased starting in 2000 for white people (APC: 11.5 percent; P <.01 for both).
Rates of nontraumatic lower-limb amputations were calculated as the number of hospital discharges with diabetes-related nontraumatic lower-limb amputations using the National Hospital Discharge Survey and National Health Interview Survey.
While the study did not examine the reasons for the trends, the researchers said it may be a result of a reduction in nontraumatic lower-limb amputation risk factors, improvements in care practice, and treatment advances. They cautioned, however, that the number of amputations may be underestimated.
Still, “the decline in national nontraumatic lower-extremity amputation rate is encouraging,” Li said. “It is consistent with other improvements in risk factors and outcomes, like peripheral arterial disease and end-stage renal disease. Effective strategies are needed to reduce disparities in amputation rate.”
Editor’s note: This story has been adapted from materials provided by the online version of Endocrine Today.
