Toe amputations are becoming more prevalent in the diabetic population. To prevent toe amputations, those individuals with the highest risk must be identified prior to developing a precipitating event. There are obvious risk factors for toe amputations, such as digital deformity, diabetic neuropathy, and ischemia. Other, less obvious, systemic comorbidities may be linked to toe amputations. This study also shows that gender plays a significant role as a risk factor for toe amputation. A foot infection, foot abscess, osteomyelitis, diabetic retinopathy, and diabetic nephropathy were also significant risk factors for toe amputations. This suggests a significant relationship between these complications and comorbidities that put these individuals at a higher risk for toe amputations.
2. Porte D, Sherwin RS, Baron A. Ellenberg & Rifkin's diabetes mellitus. 6th ed. New York: McGraw-Hill ; 2003.
3.
3. Trautner C, Haastert B, Giani G, et al. Amputations and diabetes: a case-control study . Diab Med2002;19: 35-40 .
4.
4. Leggetter S, Chaturvedi N, Fuller J, et al. Arch Intern Med2002;162: 73-78 .
5.
5. Watts S, Daly B, Anthony M, et al. The effect of age, gender, risk level and glycosylated hemoglobin in predicting foot amputation in HMO patients with diabetes . J Am Acad Nurse Pract2001;13: 230-235 .
6.
6. Flores Rivera A. Risk factors for amputation in diabetic patients: a case-control study . Archives of Medical Research1998;29: 179-184 .
7.
7. Gadsby R, McInnes A. The at-risk foot: the role of the primary care team in achieving St. Vincent targets for reducing amputation . Diabet Med1998;(Suppl 3): S61-S64 .
8.
8. Liang P. The development and complications of diabetic foot ulcers . Am J Surg1998;176(2A Suppl): 11S-19S .
9.
9. Klein R, Klein B, Moss S. Epidemiology of proliferative diabetic retinopathy . Diabetes Care1992;15: 1875-1891 .
10.
10. Klein B, Klein R, Lee K. Components of metabolic syndrome and risk of cardiovascular disease and diabetes in Beaver Dam . Diabetes Care2002;25: 1790-1794 .
11.
11. Harwell T, Helgerson S, Gohdes D, et al. Foot care practices, services and perceptions of risk among Medicare beneficiaries with diabetes at high and low risk for future complications . Foot Ankle Int2001;22: 734-738 .
12.
12. Armstrong D, Lavery L, Quebedeaux T, et al. Surgical morbidity and the risk of amputation due to infected puncture wounds in diabetic versus nondiabetic adults . J Am Podiatr Med Assoc1997;87: 321-326 .
13.
13. Trevisan R, Vedovato M, Mazzon C, et al. Concomitance of diabetic retinopathy and proteinuria accelerates the rate of decline of kidney function in type 2 diabetic patients . Diabetes Care2002;25: 2026-2031 .
14.
14. Fotieo G, Reiber G, Carter J, et al. Diabetic amputations in the VA: Are there opportunities for interventions? J Rehabil Res Dev1999;36: 55-59 .
15.
15. McMurray S, Johnson G, Davis S, et al. Diabetes education and care management significantly improve patient outcomes in the dialysis unit . Am J Kid Disease2002;40: 566-575 .
16.
16. Graves E, Owings M. 1996 summary: National Hospital Discharge Survey . Advance data from vital and health statistics; no 301. Hyattsville (MD): National Center for Health Statistics ; 1998.
17.
17. Lawrence L, Hall M. 1997 summary: National Hospital Discharge Survey . Advance data from vital and health statistics; no. 308. Hyattsville (MD): National Center for Health Statistics ; 1999.
18.
18. Hall M, Popovic J. 1998 summary: National Hospital Discharge Survey . Advance data from vital and health statistics; no. 316. Hyattsville (MD): National Center for Health Statistics ; 2000.
19.
19. Popovic J, Hall M. 1999 summary: National Hospital Discharge Survey . Advance data from vital and health statistics; no. 319. Hyattsville (MD): National Center for Health Statistics ; 2001.
20.
20. Hall M, Owings M. 2000 summary: National Hospital Discharge Survey . Advance data from vital and health statistics; no. 329. Hyattsville (MD): National Center for Health Statistics , 2002.
