Diabetes-linked amputations declining, study finds.

Fewer foot and leg amputations are being performed on people with diabetes, even as rates of the disease are rising in the United States, a new study finds. Drastic diabetes-related amputations were cut by nearly half over the past decade, researchers report in the July issue of the journal Foot & Ankle International.
Because of long-term nerve damage, people with diabetes face up to a 25 percent lifetime risk of amputation, according to prior research. For this study, researchers reviewed Medicare claims from 2000 to 2010 to see who had leg, feet and toe amputations and why.

The results surprised them. "The trend was so clear and more obvious than I thought it would be," said senior author Dr. Phinit Phisitkul, an assistant clinical professor at the University of Iowa department of orthopedics and rehabilitation. The rate for upper and lower leg amputations fell 47 percent among people with diabetes over the decade, and the rate of lower extremity amputations alone declined about 29 percent during that time period. Only partial toe amputations, which have less impact on quality of life, rose during that time period—by 24 percent. Orthopedic treatments for diabetic foot ulcers, which the authors also analyzed, rose 143 percent, the study found. Phisitkul said it's impossible to pinpoint a specific reason for the drop in major amputations. "We do know that better foot and ankle treatment is a part of it though," he said.
Also, health care teams are doing more to manage diabetic ulcers and to prevent them from occurring in the first place, he said.

Diabetes is a silent disease but it eats away at the body, Phisitkul added. "Patients need to try to fight against diabetes sooner than later, rather than waiting for complications to begin," he said.

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