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Amputations in patients attending a diabetic clinic in Addis Abeba, Ethiopia
1Department of Medicine, Yekatit 12 Hospital, Addis Abeba.
Insights
Diabetic foot amputations are a serious complication, particularly in Ethiopia. Many patients, especially those with Type 2 diabetes, face severe outcomes like sepsis or loss of independence due to prosthetic challenges.
Area of Science:
- Medical Research
- Diabetology
- Public Health
Background:
- Diabetes mellitus is a growing global health concern.
- Diabetic foot complications, including amputations, significantly impact patient morbidity and mortality.
- Limited data exists on the long-term outcomes of diabetic amputations in African populations.
Purpose of the Study:
- To investigate the incidence and outcomes of lower limb amputations in diabetic patients at Yekatit 12 Hospital, Addis Abeba, Ethiopia.
- To identify risk factors and underlying conditions associated with diabetic amputations.
- To assess the long-term survival and functional status of amputees.
Main Methods:
- A retrospective review of diabetic patients registered between 1976 and 1994.
- Analysis of patient demographics, diabetes type, underlying causes for amputation, and amputation level.
- Follow-up data on mortality, causes of death, and functional outcomes.
Main Results:
- 43 (1.9%) of 2,250 diabetic patients underwent amputation.
- Diabetic peripheral neuropathy was the most common underlying condition (21/43).
- Mortality was high (23/43), with 12 deaths attributed to sepsis in those refusing amputation.
- Below-knee amputees often lost independence due to prosthetic challenges.
Conclusions:
- Diabetic foot amputations represent a significant burden in this Ethiopian cohort.
- Timely amputation is crucial to prevent sepsis-related mortality.
- Improving access to prosthetics is essential for functional recovery and independence.
Abstract:
During 18 years, 1976 to 1994, 43(1.9%) of the 2,250 patients registered in the Diabetic Clinic at Yekatit 12 Hospital, Addis Abeba, Ethiopia (six patients) required an amputation at diagnosis or during the course of diabetes mellitus. Male to female ratios was 2:1; eight patients had Type 1 and 35 Type 2 diabetes. Diabetic peripheral neuropathy was the underlying condition in at least 21 of the 43 patients; only five cases of ischaemic gangrene were seen. Mean ge at amputation was 37.4 +/- 8.7 years in Type 1 patients and 58.6 +/- 12.1 in Type 2. Twenty-three of the 43 are now dead, 12 of the deaths having been due to sepsis in patients who refused an amputation in the face of progressing gangrene. Eleven of the 43 still attend regularly up to 11 years after an amputation. Most patients who needed below-knee amputations did not regain independence because of difficulty obtaining prostheses.