Diabetes-related lower-limb amputations up in older adults

(HealthDay)—Since 2009, diabetes-related nontraumatic lower-extremity amputation (NLEA) has been increasing among older adults, according to a study published online July 28 in Diabetes Care.

Jessica L. Harding, Ph.D., from Emory University in Atlanta, and colleagues examined NLEA trends among older adults with diabetes (≥67 years) using 100 percent Medicare claims for beneficiaries enrolled in Parts A and B.

The researchers found that NLEA rates decreased from 8.5 per 1,000 people with diabetes in 2000 to 4.4 in 2009 (annual percent change, −7.9). From 2009, NLEA rates increased to 4.8 per 1,000 people with diabetes (annual percent change, 1.2). Across most age, sex, and race/ethnic groups, trends were similar. However, absolute rates were highest in the oldest age groups, blacks, and men. Overall increases were driven by increases in rates of toe and foot NLEAs, while below-the-knee amputation and above-the-knee amputation declined. Similar to national estimates, the majority of U.S. states showed recent increases in NLEA.

"Preventive foot care has been shown to reduce rates of NLEA among adults with diabetes, and the findings of the study suggest that those with diabetes—across the age spectrum—could benefit from increased attention to this strategy," the authors write.

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