CDC report finds large decline in lower-limb amputations among U.S. adults with diagnosed diabetes

The rate of leg and foot amputations among U.S. adults aged 40 and older with diagnosed diabetes declined by 65 percent between 1996 and 2008, according to a study by the Centers for Disease Control and Prevention and published today in the journal, Diabetes Care.  The age–adjusted rate of nontraumatic lower–limb amputations was 3.9 per 1,000 people with diagnosed diabetes in 2008 compared to 11.2 per 1,000 in 1996.  Non–traumatic lower–limb amputations refer to those caused by circulatory problems that are a common complication among people with diabetes rather than amputations caused by injuries.

The study, “Declining Rates of Hospitalization for Nontraumatic Lower–Extremity Amputation in the Diabetic Population Aged 40 years or Older: U.S., 1988–2008,” is published in the current online issue of Diabetes Care.

The study also found that among people with diagnosed diabetes in 2008, men had higher age–adjusted rates of leg and foot amputations than women (6 per 1,000 vs. 1.9), and blacks had higher rates than whites (4.9 per 1,000 vs. 2.9).  Adults aged 75 years and older had the highest rate – 6.2 per 1,000 – compared to other age groups.

The study authors note that improvements in blood sugar control, foot care and diabetes management, along with declines in cardiovascular disease, are likely to have contributed to the decline in leg and foot amputations among people with diagnosed diabetes.

“The significant drop in rates of nontraumatic lower–limb amputations among U.S. adults with diagnosed diabetes is certainly encouraging, but more work is needed to reduce the disparities among certain populations,” said Nilka Ríos Burrows, M.P.H., an epidemiologist with CDC′s Division of Diabetes Translation and co–author of the study.  “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.”

The researchers analyzed data from the National Hospital Discharge Survey on non–traumatic lower–limb amputations and from the National Health Interview Survey on the prevalence of diagnosed diabetes from 1988–2008. Researchers found that the decrease in lower–limb amputation rates was greater among people with diagnosed diabetes compared to those without diabetes. However, the rate in 2008 was still about eight times higher among people with diagnosed diabetes compared to those without it.

In addition to being the leading cause of nontraumatic lower–limb amputations, diabetes is the leading cause of kidney failure and new cases of blindness among adults, and the seventh leading cause of death in the United States.  People with diabetes are at increased risk of other complications such as heart attacks, strokes and high blood pressure.

CDC′s Division of Diabetes Translation funds diabetes prevention and control programs in all 50 states, the District of Columbia, and seven U.S. territories and island jurisdictions. The National Diabetes Education Program, co–sponsored by CDC and the National Institutes of Health, provides education to improve treatment for people with diabetes, promote early diagnosis and prevent or delay the onset of type 2 diabetes. For more information visit www.cdc.gov/diabetes.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

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