The impact of diabetes on rates of amputations


The development of type I or II diabetes is associated with an increase in the risk of developing end-stage renal disease and blindness, as well as a number of other clinically relevant effects such as an increase in the risk of cardiovascular mortality and non-traumatic amputations. Iris Baumgartner, University Hospital, Bern, Switzerland, provided an overview of the magnitude of the problem faced by physicians worldwide concerning diabetes, diabetic foot and amputation.

Data from the World Health Organization indicate that the incidence of diabetes will increase significantly up to 2025, and thus the magnitude of the problem will only increase. The prevalence of peripheral arterial disease in patients with diabetes in the UK compared with those who have normal levels of glucose tolerance (22.4% and 12.5% prevalence, respectively) indicates that the development of diabetes significantly increases the risk of developing peripheral arterial disease and thus increases the risk of limb amputation if interventions are not taken rapidly. Data from the ARIC study have indicated that the probability of peripheral-arterial-disease-related hospitalisations increased in people with diabetes, as determined by 10-year follow-up, while Swedish data have also demonstrated that there is an approximately eight-fold increase in the number of lower-extremity amputations in diabetic patients compared with non-diabetic patients. However, the Inter-Society Consensus (TASC) II guidelines indicate that 85% of these amputations could be avoided with rapid treatment.