SAVING LIFE AND LIMB
February 28, 2005
Lower-leg amputations resulting from diabetes-related complications are on the rise, yet many of them are unnecessary, according to the Wall Street Journal.
Health organizations recognize the trend:
- Nationwide, more than 110,000 lower extremities were amputated in 2002, an increase from 99,522 in 1993, according to the Agency for Healthcare Research and Quality; half of them were a result of diabetes.
- The Centers for Disease Control and Prevention reports that the rate of amputation among diabetics increased 38 percent between 1992 and 2002, even when adjusted for age.
Diabetics often experience numbness in their feet due to poor blood circulation; therefore, foot wounds are slow to heal or might go unnoticed, resulting in serious infections that can require amputation.
The risk for lower-leg amputation is 15 to 40 times greater among diabetics, but many limbs can be saved with the latest medical technology, according to the American Diabetes Association.
- In 1997, doctors at the Mayo Clinic reduced the rate of amputations 50 percent by using bypass operations and angioplasty in the legs to increase blood flow, procedures that are typically used on patients with heart disease.
- Furthermore, the cost of such procedures are comparable to or cheaper than amputation; a lower-extremity amputation cost an average of $38,733 in 2002, compared with a vascular bypass ($40,000) and a noncoronary artery angioplasty ($31,388).
The key to avoiding amputation is early detection, say doctors. For diabetics, it means undergoing regular foot screenings and checking the feet regularly for wounds, even minor cuts and scrapes.
Sources: Michael J. McCarthy, "Lower-Leg Amputations are Increasing," Wall Street Journal, February 23, 2005 "Guide to Prevention Quality Indicators: Rate of Lower-extremity Amputations Among Patients With Diabetes (PQI 16)," Department of Health and Human Services, Agency for Healthcare Research and Quality, November 24, 2004; Data and Trends, "Hospitalizations for Nontraumatic Lower Extremity Amputation," Centers for Disease Control, January 18, 2005; and "Peripheral Arterial Disease in Diabetes," Diabetes and Cardiovascular Disease Review, Issue 6, American Diabetes Association.
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