Amputations and foot ulcers in patients newly diagnosed with Type 2 diabetes

NewsBot · Apr 27, 2013

Members do not see these Ads. Sign Up.
Amputations and foot ulcers in patients newly diagnosed with Type 2 diabetes mellitus and observed for 19 years. The role of age, gender and co-morbidity.
Bruun C, Siersma V, Guassora AD, Holstein P, de Fine Olivarius N.
Diabet Med. 2013 Mar 21.

AIMS:
To determine the prevalence of foot ulcers and the incidence of amputations in patients with Type 2 diabetes observed for 19 years after diagnosis. We investigated the role of gender, age and co-morbidities.

METHODS:
From the Diabetes Care in General Practice study, 1381 patients were included and examined at diabetes diagnosis, at 6 years and at 14 years after diagnosis. Register-based follow-up was for 19 years. Foot ulcers and amputations were related to gender, age and co-morbidities by odds and hazard ratios from logistic and Cox regression models, respectively.

RESULTS:
The incidence of any amputation and major amputation was 400 (95% CI 307-512) and 279 (95% CI 203-375) per 100 000 patient-years, respectively. At the three observation points, the foot ulcer prevalences were 2.76% (95% CI 1.89-3.63), 2.93% (95% CI 1.86-4.00) and 4.96% (95% CI 3.10-6.82). Multivariate analyses showed associations between foot ulcers and peripheral neuropathy, peripheral arterial disease, male gender, retinopathy and myocardial infarction. After multivariate adjustment, significant predictors (hazard ratio; 95% CI) of any amputation were peripheral neuropathy (hazard ratio 2.09; 95% CI 1.19-3.69), peripheral arterial disease (hazard ratio 3.43; 95% CI 1.65-7.12), microalbuminuria (hazard ratio 2.11; 95% CI 1.21-3.67), retinopathy (hazard ratio 6.42; 95% CI 2.59-15.90), impaired vision (hazard ratio 6.92; 95% CI 2.35-20.38) and male gender (hazard ratio 2.40; 95% CI 1.31-4.41). For women, the risk of amputation increased with age, but for men the risk was higher when diagnosed with diabetes at a younger age.

CONCLUSIONS:
Despite improved treatment regimens, the incidence of amputations is still high in this population-based patient sample. Men diagnosed with diabetes before age 65 years and patients with diabetes-related co-morbidities are at particularly high risk of foot ulcers and amputations.
Click to expand...

Admin2 · Apr 27, 2013

Related threads:
Other threads tagged with amputations

NewsBot · Jun 8, 2013

Prevalence of diabetic foot ulcers in newly diagnosed diabetes mellitus patients.
Sinharay K, Paul UK, Bhattacharyya AK, Pal SK.
J Indian Med Assoc. 2012 Sep;110(9):608-11.

Foot ulcer is one of the most common and dreadest complication of diabetes mellitus.This is also a frequent cause of hospitalisation and disability. Most of the patients with diabetic foot ulcers living in developing countries present to healthcare facilities fairly late with advanced foot ulcers because of poor economic status, inadequate knowledge of self-care, sociocultural reasons and poor and inadequate diabetes healthcare. To determine the prevalence of diabetic foot ulcers amongst the newly diagnosed diabetes mellitus patients (n = 1674) a cross-sectional study was carried out during the period January 2010 to January 2011 in the department of medicine, NRS Medical College, Kolkata. Diabetic foot ulcers were found in 4.54% newly diagnosed diabetes mellitus patients. Neuropathic type of foot ulcer was present in 46.06% of patients (52.5% in male and 38.88% in female). Ischaemic type of foot ulcer was present in 19.74% of patients (22.5% in male and in 16.66% females). Neuroischaemic type of foot ulcer was present in 34.2% of patients (25% in males and 44.44% in females). Neuropathy occurred most frequently either singly or with peripheral vascular disease. General awareness about the disease, early diagnosis and proper management will prevent this dreaded complication.
Click to expand...

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

Adequacy of Clinical Surveillance of Diabetic Patients Requiring Minor Foot Amputations

More diabetic foot amputations in those on Canagliflozin

Health service organisation impact on lower extremity amputations

Westmead study shows vitamin C prevents ulcer-related amputations

Ethnicity and diabetic amputations

A smart shoe to help reduce amputations

Major fall in diabetes-related amputations since the 1990s

Share This Page