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RD,CDE
posted: January 25th, 2012 @ 6:58pm
Declining rates of hospitalization for nontraumatic lower extremity amputation
keywords: NLEA, amputation
Section:  General Diabetes

Did you see this article in the latest issue of Diabetes Care? It's great to read how effective diabetes treatment and self-management can be.

Declining Rates of Hospitalization for Nontraumatic Lower-Extremity Amputation in the Diabetic Population Aged 40 Years or Older: U.S., 1988–2008

Here's the abstract:

OBJECTIVE To assess trends in rates of hospitalization for nontraumatic lower-extremity amputation (NLEA) in U.S. diabetic and nondiabetic populations and disparities in NLEA rates within the diabetic population.

RESEARCH DESIGN AND METHODS We calculated NLEA hospitalization rates, by diabetes status, among persons aged ≥40 years on the basis of National Hospital Discharge Survey data on NLEA procedures and National Health Interview Survey data on diabetes prevalence. We used joinpoint regression to calculate the annual percentage change (APC) and to assess trends in rates from 1988 to 2008.

RESULTS The age-adjusted NLEA discharge rate per 1,000 persons among those diagnosed with diabetes and aged ≥40 years decreased from 11.2 in 1996 to 3.9 in 2008 (APC −8.6%; P < 0.01), while rates among persons without diagnosed diabetes changed little. NLEA rates in the diabetic population decreased significantly from 1996 to 2008 in all demographic groups examined (all P < 0.05). Throughout the entire study period, rates of diabetes-related NLEA were higher among persons aged ≥75 years than among those who were younger, higher among men than women, and higher among blacks than whites.

CONCLUSIONS From 1996 to 2008, NLEA discharge rates declined significantly in the U.S. diabetic population. Nevertheless, NLEA continues to be substantially higher in the diabetic population than in the nondiabetic population and disproportionately affects people aged ≥75 years, blacks, and men. Continued efforts are needed to decrease the prevalence of NLEA risk factors and to improve foot care among certain subgroups within the U.S. diabetic population that are at higher risk.
MEMBER COMMENTS
posted: January 25th, 2012 @ 7:44pm
Re: declining rates of hospitalization for nontraumatic lower extremity amputation

Lynn: thanks for this article.  Interesting data that helps to point out how much more work we need to do around the population.  It makes me wonder if there are targeted outreach to those that are identified in the high risk. 

I'll bring this info to my areas that I work to raise the issue!

 

Warm regards,

Joan
posted: January 25th, 2012 @ 8:54pm
Re: declining rates of hospitalization for nontraumatic lower extremity amputation

The podiatry world is all abuzz with this great validation of the work that all of us on the diabetes care team are doing.  I love evidence !  Here's the article:

 

Declining Rates of Hospitalization for Nontraumatic Lower-Extremity Amputation in the Diabetic Population Aged 40 Years or Older: U.S., 1988–2008

  1. Yanfeng Li, MD, MPH1,2,
  2. Nilka Ríos Burrows, MPH2⇓,
  3. Edward W. Gregg, PHD2,
  4. Ann Albright, PHD, RD2 and
  5. Linda S. Geiss, MA2
posted: January 28th, 2012 @ 9:00am
Re: Declining rates of hospitalization for nontraumatic lower extremity amputation

Thank you Alan and Lyn

That is wonderful news!!!
posted: January 28th, 2012 @ 7:13pm
Re: Declining rates of hospitalization for nontraumatic lower extremity amputation

The number one fear folks with diabetes tell me about is amputation. It seems that growing up, every family member who had diabetes ended up having at least one amputation, and they fear that it will automatically happen to them as well. I remind them that diabetes knowledge and treatment has made huge advances in the past few years and that they truly can live a healthy and happy live with T2.