Amputation-free survival in 17,353 people at high risk for foot ulceration

     in diabetes: A national observational study


Diabetic foot ulcers and amputations are devastating and much feared complications of diabetes. Between 15% and 34% of people with diabetes develop a foot ulcer during their lifetime, with more than half acquiring infections that may result in lower extremity amputations causing disability, extensive periods of hospitalisation, and premature mortality. The incidence of major amputation ranges from 0·2 to 2·0 per 1000 people in those with diabetes. Major or minor amputation also increases the risk of additional subsequent amputations. Foot ulcers are the costliest microvascular complication of diabetes … Amputations in people with diabetes have a significant impact on ambulation, body care, movement and mobility, resulting in an inability to perform daily tasks and often a loss of employment impacting on the wider family. Clinical epidemiology studies suggest that foot ulcers precede around 85% of non-traumatic lower extremity amputations in individuals with diabetes [8] and hence ulcer prevention is important. Previous studies have reported that apart from severity of ulcer, age [9], low socioeconomic status, smoking, sex, renal impairment, ischaemic heart disease, diabetic neuropathy, glucose levels and peripheral arterial disease are some of the important factors associated with the risk of amputation. Identifying a person’s risk of foot ulceration helps in directing scarce resources to those most at need. Assessment of individual risk factors … read more