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Updated: Jun 4, 2026

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Published on: February 17, 2023
The 25-year cumulative incidence of lower extremity amputations in people with type 1 diabetes
Karine Sahakyan1, Barbara E K Klein, Kristine E Lee
1Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA. sahakyan@epi.ophth.wisc.edu
Objective:
To examine the 25-year cumulative incidence of lower-extremity amputation (LEA) in people with type 1 diabetes.
Research Design And Methods:
Cumulative incidence of LEA was ascertained in Wisconsin Epidemiologic Study of Diabetic Retinopathy participants (n = 943) using the Kaplan-Meier approach accounting for competing risk of death. Relationships of baseline characteristics with incidence of LEA were explored using a proportional hazards approach with discrete linear regression modeling.
Results:
The overall 25-year incidence of LEA was 10.1%. In multivariate analyses (results reported as odds ratio; 95% CI), being male (3.90; 2.29-6.65), heavy smoking (2.07; 1.11-3.85), having hypertension (3.36; 1.91-5.93), diabetic retinopathy (2.62; 1.13-6.09), neuropathy (1.68; 1.02-2.76), and higher HbA(1c) (per 1% 1.40; 1.24-1.58) were independently associated with the incidence of LEA.
Conclusions:
Our results show a high 25-year incidence of LEA and suggest that glycemic control and blood pressure control and preventing heavy smoking may result in reduction in its incidence.
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