Blog | Monday, January 30, 2012

QD: News Every Day--Diabetic amputation rates falling


Diabetic lower extremity amputations declined significantly in the U.S. diabetic population from 1996 to 2008, a study found, although amputations continued to be substantially higher in diabetics than in nondiabetics and disproportionately affected people aged more than 75 years old, blacks and men.

Researchers calculated amputation hospitalization rates by diabetes status among those ages greater than 40 years on the basis of National Hospital Discharge Survey data and National Health Interview Survey data on diabetes prevalence from 1988 to 2008. Results appeared in Diabetes Care.

Although the number of U.S. residents with diagnosed diabetes increased dramatically from 5.4 million in 1988 to 17.1 million in 2008, the estimated number of diabetes-related amputation discharge codes increased only from 52,868 in 1988 to a peak of 83,153 in 1996, and then decreased to 70,139 in 2008, the authors wrote.

Age-adjusted amputation rates for the diabetic population increased in the early 1990s and then declined by 8.6% annually between 1996 and 2008 (P less than 0.01). With change over the entire study period accounted for, the average annual percentage change in age-adjusted amputation rates was 24.9% (P less than 0.05) in the diabetic population and 0.7% (P greater than 0.05) in the nondiabetic population.

The absolute change in rates between 1988 and 2008 was also greater in the diabetic population than in the nondiabetic population (5.4 vs. 0.03 per 1,000 persons). Despite the much greater decrease in amputation rates in the diabetic population, in 2008 the age-adjusted amputation rate in the diabetic population was still nearly eight times the rate in the nondiabetic population (3.9 vs. 0.5 per 1,000 persons).

But, the authors noted, diabetes and its related amputations continues to disproportionately affects people aged greater than 75 years, blacks, and men.

"[O]ur finding that the reduction in rates was substantially higher in the diabetic population than in the nondiabetic population suggests that the rate reduction in the diabetic population may be partly attributable to improved diabetes care management, differential risk factor improvement, or the differential impact of such improvements," the authors concluded.