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  • Sharp fall in lower...

Sharp fall in lower extremity amputations due to type 1 diabetes lately, finds study

Written By : Hina Zahid |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-11-03T09:00:04+05:30  |  Updated On 3 Nov 2021 9:00 AM IST
Sharp fall in lower extremity amputations due to type 1 diabetes lately, finds study
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Amputation in type 1 diabetes is becoming relatively less common in Sweden. The rate has fallen by just over 40 percent over an approximately 20-year period, a University of Gothenburg study shows. The results are based on registry data on 46,088 people with type 1 diabetes in the years 1998–2019. The study involved linking data from the Swedish National Diabetes Register, the National Patient Register and a couple of other Swedish national registers.

The results have been published in the journal Diabetologia.

The researchers studied how the incidence of amputations changed over time, and also conducted a survey of risk factors for amputation in people with type 1 diabetes.

The average age of the patients covered by the data when they were included in the study was 32 years. At the time, none of them had undergone amputations. Fifty-five percent were men and 45 percent women.

Trend reversal for the better

Initially, in the years 1998–2001, the probability of amputation was 2.84 per 1,000 people on an annual basis. In the last few years of the study, 2017–2019, the corresponding figure was 1.64/1,000. The proportion of people undergoing amputation annually thus fell by 42 percent.

The study's first author is Sara Hallström, a doctoral student in molecular and clinical medicine at Sahlgrenska Academy, University of Gothenburg, and specialist doctor in internal medicine at Sahlgrenska University Hospital.

"We see a trend reversal in the period from 2014 to 2016, and a couple of years before that there were evidently declining long-term blood sugar levels and improving kidney function. These are the risk factors that, in the study, proved to be the major ones for amputation in people with type 1 diabetes," Hallström says.

Other risk factors identified were advanced age, male sex, cardiovascular disease, smoking, and high blood pressure.

More care, less suffering

In the researchers' view, the improvement in prognosis is probably due to development of diabetes care in recent years. Intensive treatment of risk factors subject to influence using, for example, continuous blood-glucose measurement and advanced insulin pumps, is now underway. Multidisciplinary diabetes foot teams have also been introduced.

The team helps patients with foot wounds that do not heal readily, owing to the vascular changes and impairment in sensation that diabetes can cause. Eventually, nonhealing wounds may necessitate amputations of the foot, and in more severe cases also of the lower legs and thighs.

"The declining amputation rate for people with diabetes is important, given that amputation is a procedure that causes great suffering and disability for those who have to undergo it," Hallström says.

https://link.springer.com/article/10.1007/s00125-021-05550-z


diabetologiatype 1 diabetesamputation
Hina Zahid
Hina Zahid

    Hina Zahid Joined Medical Dialogue in 2017 with a passion to work as a Reporter. She coordinates with various national and international journals and association and covers all the stories related to Medical guidelines, Medical Journals, rare medical surgeries as well as all the updates in the medical field. Email: editorial@medicaldialogues.in. Contact no. 011-43720751

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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