There has been a large drop in the rate of leg and foot amputations among Americans aged 40 and over with diagnosed diabetes, according to a new study by the US Centers for Disease Control and Prevention (CDC) published in the February issue of Diabetes Care. The study reports that between 1996 and 2008 the rate of such amputations fell by 65%.

The authors suggest the most likely reason for this large drop in leg and foot amputations among people with diagnosed diabetes is improvements in blood sugar control, foot care and management of diabetes. Reduction in rates of cardiovascular disease is also likely to have contributed, they said.

For their study, the authors used data from the National Hospital Discharge Survey and the National Health Interview Survey.

They report that after adjusting for age, the rate of non-traumatic lower-limb amputations was 3.9 per 1,000 people with diagnosed diabetes in 2008. This compares with a much higher 11.2 per 1,000 in 1996.

However, in 2008 the rate was still about eight times higher among people with diagnosed diabetes than those without it.

Non-traumatic lower-limb amputations refers to those caused by problems in blood circulation, as opposed to amputations due to injuries.

The study also shows that in 2008:

  • Rates of leg and foot amputation were higher for men (6 per 1,000) with diagnosed diabetes than for women with the condition (1.9 per 1,000).
  • Blacks had higher rates than whites (4.9 vs 2.9 per 1,000).
  • Adults aged 75 and over had the highest rate of all the age groups (6.2 per 1,000).

Co-author Nilka Ríos Burrows, an epidemiologist with CDC′s Division of Diabetes Translation, said in a statement although the figures are encouraging, more work was needed to reduce the disparities across population groups, and:

“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.”

Diabetes is also the leading cause of kidney failure, new cases of blindness in adults, and the seventh leading cause of death among Americans. Diabetes also puts people at higher risk for other conditions such as heart attacks, strokes and high blood pressure.

Written by Catharine Paddock PhD