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Diabetes- and nondiabetes-related lower extremity amputation incidence before and after the introduction of better organized diabetes foot care: Continuous longitudinal monitoring using a standard method

Lookup NU author(s): Professor Nigel Unwin, Dr William Kelly


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OBJECTIVE - There is a lack of continuous longitudinal population-based data on lower extremity amputation (LEA) in the U.K. We present here accurate data on trends in diabetes-related (DR) LEAs and non-DRLEAs in the South Tees area over a continuous 5-year period. RESEARCH DESIGN AND METHODS - All cases of LEA from 1 July 1995 to 30 June 2000 within the area were identified. Estimated ascertainment using capture-recapture analysis approached 100% for LEAS in the area. Data were collected longitudinally using the standard method of the Global Lower Extremity Amputation Study protocol. RESULTS - Over 5 years there were 454 LEAs (66.3% men) in the South Tees area, of which 223 were diabetes related (49.1%). Among individuals with diabetes, LEA rates went from 564.3 in the first year to 176.0 of 100,000 persons with diabetes in the fifth year. Over the same period, non-DRLEAs increased from 12.3 to 22.8 of 100,000 persons without diabetes. The relative risk of a person with diabetes undergoing an LEA went from being 46 times that of a person wit out diabetes to 7.7 at the end of the 5 years. The biggest improvement in LEA incidence was seen in the reduction of repeat major DRLEAs. CONCLUSIONS - Our data show that in the South Tees area at a time when major non-DRLEA rates increased, major DRLEA rates have fallen. These diverging trends mark a significant improvement in care for patients with diabetic foot disease as a,result of better organized diabetes care.

Publication metadata

Author(s): Canavan RJ, Unwin NC, Kelly WF, Connolly VM

Publication type: Article

Publication status: Published

Journal: Diabetes Care

Year: 2008

Volume: 31

Issue: 3

Pages: 459-463

ISSN (print): 0149-5992

ISSN (electronic): 1935-5548

Publisher: American Diabetes Association


DOI: 10.2337/dc07-1159


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