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Long-term incidence of lower-extremity amputations in a diabetic population.
Arch Fam Med 1996 Jul-Aug; 5(7):391-8AF

Abstract

OBJECTIVE

To describe the 10-year cumulative incidence of and risk factors for lower-extremity amputations in diabetics.

DESIGN

Cohort study.

SETTING

Primary care.

PARTICIPANTS

Population-based sample (N = 879) of younger-onset diabetic persons (in whom diabetes was diagnosed before 30 years of age and who were taking insulin) and a stratified random sample (N = 956) of older-onset diabetic persons (diagnosis at or after 30 years of age) participating in baseline, 4-year, and 10-year examinations.

MAIN OUTCOME MEASURE

Amputations of the lower extremities as reported by the participants.

RESULTS

The 10-year cumulative incidence of lower-extremity amputation was 5.4% in younger-onset and 7.3% in older-onset persons. Multivariate analyses were performed by logistic regression. In younger-onset persons, age (odds ratio [OR] for 10 years, 2.0; 95% confidence interval [CI], 1.5-2.8), history of ulcers (OR,4.8; 95% CI, 2.3-9.9), diastolic blood pressure (OR, 2.1 for 10 mm Hg; 95% CI, 1.5-3.0), glycosylated hemoglobin level (OR, 1.4 for 1%; 95% CI, 1.2-1.6), sex (OR, 5.2 for men; 95% CI, 2.2-12.3), and retinopathy (OR, 1.2 for 2 steps; 95% CI, 1.1-1.4) were significantly associated with incidence of lower-extremity amputation. In older-onset persons, history of ulcers (OR, 3.3; 95% CI, 1.6-6.8), glycosylated hemoglobin level (OR, 1.3 for 1%; 95% CI, 1.1-1.5), duration of diabetes (OR, 1.6 for 10 years; 95% CI, 1.1-2.5), sex (OR, 2.6 for men; 95% CI, 1.3-4.9), diastolic blood pressure (OR, 0.7 for 10 mm Hg; 95% CI, 0.5-1.0), and proteinuria (OR, 2.4; 95% CI, 1.0-5.7) were significantly associated with incidence of lower-extremity amputation.

CONCLUSION

These data show there are several risk factors for lower-extremity amputation with potential for modification and preventive strategies.

Authors+Show Affiliations

Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

8664997

Citation

Moss, S E., et al. "Long-term Incidence of Lower-extremity Amputations in a Diabetic Population." Archives of Family Medicine, vol. 5, no. 7, 1996, pp. 391-8.
Moss SE, Klein R, Klein BE. Long-term incidence of lower-extremity amputations in a diabetic population. Arch Fam Med. 1996;5(7):391-8.
Moss, S. E., Klein, R., & Klein, B. E. (1996). Long-term incidence of lower-extremity amputations in a diabetic population. Archives of Family Medicine, 5(7), pp. 391-8.
Moss SE, Klein R, Klein BE. Long-term Incidence of Lower-extremity Amputations in a Diabetic Population. Arch Fam Med. 1996;5(7):391-8. PubMed PMID: 8664997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term incidence of lower-extremity amputations in a diabetic population. AU - Moss,S E, AU - Klein,R, AU - Klein,B E, PY - 1996/7/1/pubmed PY - 1996/7/1/medline PY - 1996/7/1/entrez SP - 391 EP - 8 JF - Archives of family medicine JO - Arch Fam Med VL - 5 IS - 7 N2 - OBJECTIVE: To describe the 10-year cumulative incidence of and risk factors for lower-extremity amputations in diabetics. DESIGN: Cohort study. SETTING: Primary care. PARTICIPANTS: Population-based sample (N = 879) of younger-onset diabetic persons (in whom diabetes was diagnosed before 30 years of age and who were taking insulin) and a stratified random sample (N = 956) of older-onset diabetic persons (diagnosis at or after 30 years of age) participating in baseline, 4-year, and 10-year examinations. MAIN OUTCOME MEASURE: Amputations of the lower extremities as reported by the participants. RESULTS: The 10-year cumulative incidence of lower-extremity amputation was 5.4% in younger-onset and 7.3% in older-onset persons. Multivariate analyses were performed by logistic regression. In younger-onset persons, age (odds ratio [OR] for 10 years, 2.0; 95% confidence interval [CI], 1.5-2.8), history of ulcers (OR,4.8; 95% CI, 2.3-9.9), diastolic blood pressure (OR, 2.1 for 10 mm Hg; 95% CI, 1.5-3.0), glycosylated hemoglobin level (OR, 1.4 for 1%; 95% CI, 1.2-1.6), sex (OR, 5.2 for men; 95% CI, 2.2-12.3), and retinopathy (OR, 1.2 for 2 steps; 95% CI, 1.1-1.4) were significantly associated with incidence of lower-extremity amputation. In older-onset persons, history of ulcers (OR, 3.3; 95% CI, 1.6-6.8), glycosylated hemoglobin level (OR, 1.3 for 1%; 95% CI, 1.1-1.5), duration of diabetes (OR, 1.6 for 10 years; 95% CI, 1.1-2.5), sex (OR, 2.6 for men; 95% CI, 1.3-4.9), diastolic blood pressure (OR, 0.7 for 10 mm Hg; 95% CI, 0.5-1.0), and proteinuria (OR, 2.4; 95% CI, 1.0-5.7) were significantly associated with incidence of lower-extremity amputation. CONCLUSION: These data show there are several risk factors for lower-extremity amputation with potential for modification and preventive strategies. SN - 1063-3987 UR - https://www.unboundmedicine.com/medline/citation/8664997/Long_term_incidence_of_lower_extremity_amputations_in_a_diabetic_population_ L2 - https://medlineplus.gov/diabeticfoot.html DB - PRIME DP - Unbound Medicine ER -