Lower extremity amputation is devastating to any person and is a very real complication for a diabetic. Identifying early risk factors is tantamount to saving a limb. This study used the national hospital discharge survey to identify 2206 control patients and 2098 diabetic patients with a lower extremity amputation. These patients were not limited based on gender or race as in previous studies. The results show that nephropathy and retinopathy are early predictors.
Hamalainen H, Ronnemaa T, Halonen JP, et al.Factors predicting lower extremity amputations in patients with type 1 or type 2 diabetes mellitus: a population based 7 year follow up study. J Int Med1999;246:97-103.
2.
Knuiman MW, Welborn TA, McCann VJ, et al.Prevalence of diabetic complications in relation to risk factors. Diabetes1986;35:1332-1339.
3.
Orchard TJ, Dorman JS, Maser RE, et al.Factors associated with avoidance of severe complications after 25 years of IDDM. Diabet Care1990;13:741-747.
4.
Lloyd CE, Orchard TJ.Diabetes complications: the renal-retinal link. Diabet Care1995;18:1034-1036.
5.
Gabir MM, Hanson RL, Dabela D, et al.Plasma glucose and prediction of microvascular disease and mortality. Diabet Care2000;23:1113-1118.
6.
Nathan DM.Long term complications of diabetes mellitus. N Engl J Med1993;328:1676-1685.
7.
Hirsch IB.Surveillance for complications of diabetes. Postgrad Med1996;99:147-155, 159-162.
8.
Krolewski AS, Warram JH, Freire MB.Epidemiology of late diabetic complications. Endocrinol Metabol Clin North Am1996;25:217-239.
9.
Apelqvist J, Larsson J.What is the most effective way to reduce the incidence of amputation in the diabetic foot?Diabet Metabol Res Rev2000;16:S75-S83.
10.
Mayfield J, Reiber G, Nelson R, et al.A foot risk classification system to predict diabetic amputation in Pima Indians. Diabet Care1996;19:702-709.
11.
Lee J, Lu M, Lee V, Russell D, et al.Lower extremity amputation incidence, risk factors, and mortality in the Oklahoma Indian Diabetes Study. Diabetes1993;42:876-882.
12.
Lehto S, Ronnemaa T, Pyorala K, et al.Risk factors predicting lower extremity amputations in patients with NIDDM. Diabet Care1996;19:607-612.
13.
Moss SE, Klein R, Klein BE.Long-term incidence of lower-extremity amputations in a diabetic population. Arch Fam Med1996;5:391-398.
14.
Moss SE, Klein R, Klein BE.The 14-year incidence of lower-extremity amputations in a diabetic population. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. Diabet Care1999;22:951-959.
15.
Chaturvedi N, Stevens LK, Fuller JH, et al.Risk factors, ethnic differences and mortality associated with lower-extremity gangrene and amputation in diabetes. The WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia2001;44:S65-S71.
16.
Adler AI, Boyko EJ, Ahroni JH, et al.Lower-extremity amputation in diabetes. The independent effects of peripheral vascular disease, sensory neuropathy, and foot ulcers. Diabet Care1999;22:1029-1035.
17.
Selby JV, Zhang D.Risk factors for lower extremity amputation in persons with diabetes. Diabet Care1995;18:509-516.
18.
Lawrence L, Hall MJ.1997 Summary: National Hospital Discharge Survey. Advance data from vital and health statistics; no. 308. Hyattsville, MD: National Center for Health Statistics; 1999.
19.
Hall MJ, Popovic JR.1998 Summary: National Hospital Discharge Survey. Advance data from vital and health statistics; no. 316. Hyattsville, MD: National Center for Health Statistics; 2000.
20.
Popovic JR, Hall MJ.1999 Summary: National Hospital Discharge Survey. Advance data from vital and health statistics; no. 319. Hyattsville, MD: National Center for Health Statistics; 2001.
