The diabetic foot : how to save a limb : part II

Abstract

The age standardized incidence rate of lower limb amputations in diabetics is 13.1 times (95% Cl 9-17.2) greater than for the general population. The incidence of diabetes related lower limb amputations is 475 per 100,000 patients years or 10.2 per 100,000 patients per year. Extrapolating this to our own population, we would expect to have no more than 50 major amputations per year. If we take into account the higher prevalence of diabetes in our country we should not have more than 80 major amputations per year. As can be seen in this article, the number of major amputations per year in our country has been static at around 120 per year. Figure 2 in this article shows that there is also a considerable number of minor amputations carried out per year, the numbers of which have again remained relatively stable in the past five years. Clearly the numbers performed locally are far in excess of those recorder in other countries. This bags the question of why our amputation rates are so high and what can we do to try to reduce this avoidable tragedy?