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Risk factors for amputation in diabetic patients: a case-control study

A R Flores Rivera1

  • 1Unidad de Investigación Médica, Hospital General de Zona con Medicina Familiar No. 1, Instituto Mexicano del Seguro Social, Pachuca, Hidalgo, Mexico.

Archives of Medical Research
|July 3, 1998
PubMed
Summary

Diabetic patients face amputation risks from neuropathy, vascular disease, and poor foot care. Patient education and daily foot hygiene are key to preventing lower extremity amputations.

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Area of Science:

  • Endocrinology
  • Vascular Surgery
  • Diabetology

Background:

  • Diabetes mellitus is a leading cause of lower extremity amputation.
  • Quantifying risk factors is crucial for developing effective prevention strategies.

Purpose of the Study:

  • To identify and quantify risk factors associated with lower extremity amputation in male patients with diabetes mellitus.
  • To inform preventive measures aimed at reducing amputation rates.

Main Methods:

  • A case-control study involving 80 diabetic males undergoing supracondyle amputation and 240 controls.
  • Data collected included socioeconomic, psychosocial, clinical, and self-care factors.
  • Statistical analysis identified significant risk factors using odds ratios and confidence intervals.

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Main Results:

  • Key risk factors identified: absence of lower leg vibratory perception (OR=14.9), peripheral vascular disease (OR=8.9), low blood albumin (OR=7.9), obesity (OR=4.2), and diabetes duration >10 years (OR=3.47).
  • Other significant factors included high blood cholesterol, hyperurea blood nitrogen, foot cracks, prolonged foot soaking, and lack of diabetes education.
  • Ingrown toenails (OR=2.0) and feet soaked in water (OR=1.8) were also noted.

Conclusions:

  • Multiple risk factors contribute to lower extremity amputation in diabetic patients.
  • Preventive strategies should focus on patient education, glycemic control, meticulous foot hygiene, and appropriate footwear.
  • Interventions targeting these modifiable factors hold potential for reducing amputation rates.