Good news for diabetics?

By ACSH Staff — Feb 06, 2012
Limb amputation necessitated by severe circulatory problems is one of the most frightening risks that diabetics face.

Limb amputation necessitated by severe circulatory problems is one of the most frightening risks that diabetics face. Thus the results of a new study conducted by the Centers for Disease Control and Prevention (CDC) provide welcome news: Lower-limb amputations due to diabetes complications dropped 65 percent from 1996 to 2008, the researchers report in Diabetes Care.

For the study, researchers analyzed data from two national surveys that had addressed diabetes prevalence and nontraumatic lower-extremity amputations (most typically associated with diabetes) among people aged 40 and over. Both surveys evaluated data from 1988 through 2008, reporting an overall decline in amputations beginning in 1996. Among the demographic studied, the rate of nontraumatic limb amputations was 11.2 per 1,000 people in 1996; in 2008, it was 3.9 per 1,000.

The study authors suggest that the declining rate of this type of amputation may be due to a number of factors within the diabetic population, including improved management of foot care, lowered rates of cardiovascular disease, and better blood sugar control. Diabetics have a high risk of infectious complications in the feet as a result of diminished sensation from nerve damage and inadequate blood supply; these infections are the most common precursor to amputation.

However, ACSH s Dr. Josh Bloom points out a possible confounding factor that may not have been adequately addressed in the study. As the researchers acknowledge, despite this drop in lower-limb amputations, the rate of diabetes in the U.S. has dramatically increased in the past 20 years from 5.4 million in 1998 to 17.1 million in 2008. Given that the prevalence of obesity-related diabetes is increasing, says Dr. Bloom, it s quite possible that there are now many more early-stage diabetics than were included in the older data, which means that most of them haven t yet begun to have the kind of circulatory problems that result in amputation. The drugs available for diabetes in 2008 were not that different from those used in 1996. There must be something more going on here.

And while ACSH s Dr. Ruth Kava notes that it s impressive if better management of diabetes is indeed responsible for the decline in amputations, greater prevention of obesity-related (type 2) diabetes is ultimately most desirable, considering the host of other complications diabetic individuals are prone to.

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