CDC: Big Drop in Diabetes Amputations

65% Lower Rate of Foot, Leg Amputations in Just Over a Decade

By Salynn Boyles
WebMD Health News

Reviewed by Brunilda Nazario, MD

Jan. 24, 2012 -- There has been a dramatic drop in the rate of diabetes-related amputations in the U.S., and experts attribute the improvement to better management of risk factors that lead to the loss of feet and legs.

The amputation rate declined by 65% among adults with diabetes in a little over a decade, the CDC reports.

Foot and leg amputations occurred in 4 out of every 1,000 adults with diabetes in 2008, compared to 11 out of every 1,00 in 1996, the CDC reports.

Non-injury-related amputation rates were still eight times higher among those with diabetes than adults without the disease.

Nevertheless, the decline shows that efforts to reduce the complications of diabetes are having a major impact, says American Diabetes Association President of Medicine and Science Vivian Fonseca, MD.

"This is very encouraging and important news for people with diabetes," he says. "The decline confirms the tremendous progress we have made in translating research into practice."

Diabetes-Related Amputations Down

Nerve damage or neuropathy is a common complication of diabetes, especially among people who have had the disease for many years.

Poor control of diabetes, such as prolonged high blood sugar, low insulin levels, and high blood pressure, are believed to be major contributors to diabetes-related nerve damage.

According to this new study, foot and leg amputation rates serve as an important gauge of the effectiveness of efforts to reduce diabetes complications by controlling these risk factors.

Researchers analyzed data from two national surveys to determine the prevalence of diabetes-related leg and foot amputations in adults aged 40 and over.

Among the major findings:

  • Between 1996 and 2008, the rate of leg and foot amputations among adults with diabetes declined by 65%, with men having three times the rate of amputations as women (6 per 1,000 vs. 2 per 1,000).
  • Amputation rates were higher among blacks than whites (5 per 1,000 vs. 3 per 1,000).
  • Those over the age of 75 had the highest rate of amputations.

The study will appear in the February issue of the journal Diabetes Care.

Keep a Close Eye on Your Feet

While the decline is encouraging, CDC epidemiologist Nilka Rios Burrows, MPH, says much more could be done to reduce amputation rates among diabetic people.

"The message to patients and their doctors is that addressing the modifiable risk factors for diabetes complications can have a huge impact," she says.

That means aggressive medical management of blood pressure, blood sugar, and cholesterol, maintaining a healthy lifestyle, and keeping a close eye on your feet.

"A foot exam should be part of every medical visit," Burrows says. "If the doctor doesn't mention it, the patient should. And people with diabetes should check their own feet every day to look for sores or injury."

Other recommendations for diabetic people from the CDC's National Diabetes Education Program include:

  • Wash your feet every day, keep feet soft with lotion or petroleum jelly, smooth corns and calluses gently, and trim toenails frequently.
  • Wear shoes and socks at all times to minimize the risk of injury.
  • Protect feet from extreme heat and cold.
  • Remain active and do other things to promote blood flow to feet.
  • Discuss foot care with your doctor.

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SOURCES: Li., Y. Diabetes Care, February 2012.Nilka Rios Burrows, MPH, epidemiologist, CDC Division of Diabetes Translation.Vivian Fonseca, MD, president of medicine & science, American Diabetes Association.News release, CDC.CDC: "Take Care of Your Feet for a Lifetime."

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