Amputations among diabetics in Reunion Island

Our study allowed us to exhaustively list up all the cases of lower limb amputation carried out in the hospitals of the island from May 1st, 2000 to April 30, 2001.

We studied the medical files of all the diabetic patients having undergone a non traumatic amputation and they all had an interview with an inquiring doctor.

406 amputations (including 11 traumatic ones) have been carried out over the 12 months of our study. On a total of 395 non traumatic amputations, 70% were made among diabetics and concerned 278 patients among whom 179 are type 2 diabetics. Men are more concerned than women. If the distribution of amputation levels does not differ between diabetics and non-diabetics, the former more often undergo multiple interventions. 72% of the patients have a level of primary education, 59% have difficulties reading, and most of them have a very limited knowledge on their disease and do not practise any prevention for podologic traumatism.

In a region where 718 220 inhabitants live and where the rate of diabetes prevalence is high (17.7% for 30-69 years), we could be afraid for the years to come of an important increase of the prevalence and diabetes chronic complications incidence rates. Authorities have to become aware of the current risks and of increasing equipments and personnel for the prevention and the follow-up of this insidious pathology. Programmes for the prevention of podologic complications should be supported by taking into account local specificities.