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Lower-limb amputations have declined among diabetics, study finds

By Jeannine Stein, Los Angeles Times –

Here’s some good news for a change from the diabetes front: Lower-limb amputations due to diabetes complications dropped 65 percent from 1996 to 2008.

In a study published this week in the journal Diabetes Care, researchers from the Centers for Disease Control and Prevention analyzed data from two national studies that looked at diabetes prevalence and nontraumatic lower-extremity amputations among people age 40 and over. Those types of amputations are typically caused by circulation problems due to diabetes, not by injuries.

Both surveys tracked numbers from 1988 to 2008, but overall declines in amputations were noted beginning in 1996. In 1996 the age-adjusted rate of nontraumatic limb amputations among those with diabetes was 11.2 per 1,000 people, and in 2008 it was 3.9 per 1,000 people.

Men had higher rates than women, and blacks had higher rates than whites. When broken down by age, those older than 75 had the highest rate at 6.2 per 1,000 people.

“The significant drop in rates of nontraumatic lower-limb amputations among U.S. adults with diagnosed diabetes is certainly encouraging, but more work is needed to reduce the disparities among certain populations,” said co-author Nilka Rios Burrows of the CDC in a news release.

The study authors pegged the declining numbers to several factors, including better management of foot care and diabetes, drops in rates of cardiovascular disease, and better blood sugar control.

But this doesn’t mean we’re out of the woods. The study points out that despite amputation rates falling, the rates of people being diagnosed with diabetes in the U.S. has gone up drastically in the past 20 years, from 5.4 million in 1998 to 17.1 million in 2008.

Also, the rate of nontraumatic lower-extremity limb amputations in 2008 was about eight times higher among those with diabetes that in the regular population. Added Burrows, “We must continue to increase awareness of the devastating health complications of diabetes. Diabetes is the leading cause of lower-limb amputations in the United States.”

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