Lower Limb Amputation Rates Have Dropped


By: Brenda Neugent

Despite an increase in diabetes cases nationwide, fewer people with diabetes are facing lower leg and foot amputations than a decade ago, according to the results of a new study.

Because diabetes leads to circulation problems and nerve damage, those who develop the disease are at a higher risk of amputation, especially when faced with slow-to-heal diabetic foot ulcers. Research has suggested that at many as 25 percent of people with diabetes will face amputation.

But according to the study, those numbers are dropping. Led by researchers at the University of Iowa, the study was based on Medicare Part B claims from 2000 to 2010, which showed that the rate of lower extremity amputations dropped 28.8 percent, even as the number of orthopedic treatment claims for diabetic foot ulcers increased 143.3 percent.

In many cases, researchers said, lower extremity amputations have been replaced by partial toe amputations, allowing for better outcomes.

“Amputations at the upper and lower leg level are down 47 percent, while amputations at the partial toe level increased by 24 percent. What this means for patients is increased mobility, independence and survival rates,” said senior author Dr. Phinit Phisitkul.

Researchers said that although additional studies are needed to determine the exact causes of the decrease, they said improved preventive care, insulin control, and orthopedic treatment of diabetic foot ulcers are most likely the biggest contributors to the decline.

According to Dr. Bill Releford, founder of the Releford Foot & Ankle Institute in Beverly Hills, as many as 75 percent of all amputations are preventable. He offered the following tips in a recent press release:

* Do not smoke.

* Exercise daily

* Control your cholesterol.

* Dry in between all toes after bathing.

* Always control your diabetes and blood pressure.

* Always wear shoes made from natural sources such as calfskin or soft leathers.

* Never pull or pick skin from your feet.

* Eat at least five colors of fruits and vegetables every day.

* Never cut toenails or trim calluses if you have diabetes or poor circulation. See a podiatrist for routine foot care.

* Never go barefoot if you have diabetes, even at home.

The study appeared in the journal Foot & Ankle International.



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