Diabetes Amputations Declining

A new study has found that fewer foot and leg amputations are being done on people with diabetes, even as the number of diabetic people increases.

Over the past decade the number of diabetes-related amputation were cut in half. In prior research, people with diabetes have a 25 percent lifetime risk of amputation. The new study, done between 2000 to 2010, really surprised the researchers. The results showed that the rate for upper and lower leg amputations fell by 47 percent, and by 29 percent for lower extremity amputations. Only partial toe amputations had risen by 24 percent. The study also found that orthopedic treatments for diabetic foot ulcers rose 143 percent. The researchers stated that the main reason for these results is “better foot and ankle treatment.” Not only that but health care teams are also doing more to manage diabetic ulcers and to prevent them happening.

About 26 million people have diabetes in the United States, and the majority of those people have type 2 diabetes, which is associated with overweight and sedentary. Withing the next 20 years, based on current projections, that number will rise up to 44 million people.

One of the main reasons people with diabetes get amputations is because they don’t produce enough hormone insulin to properly convert food into energy. The body gets too much sugar in the blood, which then causes nerve damage that can reduce feeling in the feet, leading to the development of sores or ulcers. If the ulcers become severely infected, life-saving amputations may be needed.

The United States lags behind other countries in terms of diabetes foot care, said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City. In the United States, numerous insurance agencies won’t cover prevention of diabetic foot issues, Zonszein demonstrated. There is proof that contact casting, surgery that releases (lengthens) the Achilles tendon and calf muscles can help, however since numerous payers won’t repay the expenses for the method, not many specialists utilization it, he said. Teaching proper foot care is also an important aspect of preventing ulcers from occurring, but this also falls under prevention, which isn’t paid for. With the right treatment, only 30 percent of ulcers recur, said Phisitkul.

Although there are new ways to prevent foot ulcers and amputations, patients must assume a role to help prevent the ulcers as well. “Patients need to try to fight against diabetes sooner than later, rather than waiting for complications to begin,” Phisitkul said.

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