Reduced Incidence of Lower-Extremity Amputations in People with Diabetes in Scotland
A nationwide study
- Brian Kennon, MD1⇓,
- Graham P. Leese, MD2,
- Lynda Cochrane, PHD3,
- Helen Colhoun, MD4,
- Sarah Wild, MBBCHIR, PHD5,
- Duncan Stang, DIP, POD, MED6,
- Naveed Sattar, PHD7,
- Donald Pearson, FRCP8,
- Robert S. Lindsay, FRCP9,
- Andrew D. Morris, MD10,
- Shona Livingstone, MSC11,
- Matthew Young, MD12,
- John McKnight, MD13 and
- Scott Cunningham, BSC(HONS)14
- 1Diabetes & Endocrinology Department, Southern General Hospital, Glasgow, U.K.
- 2Diabetes & Endocrinology Department, Ninewells Hospital, Dundee, Tayside, U.K.
- 3Division of Clinical and Population Sciences and Education, Dundee, Tayside, U.K.
- 4Public Health Wellcome Trust Centre for Molecular Medicine Clinical Research Centre, University of Dundee, Dundee, Tayside, U.K.
- 5Public Health, University of Edinburgh, Lothian, U.K.
- 6Podiatry Department, Hairmyres Hospital, East Kilbride, Lanarkshire, U.K.
- 7Institute of Cardiovascular and Medical Sciences, University of Glasgow, Strathclyde, U.K.
- 8University of Aberdeen, Diabetes King’s College, Aberdeen, Grampian, U.K.
- 9British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Strathclyde, U.K.
- 10Biomedical Research Institute, University of Dundee, Tayside, U.K.
- 11Statistics Department, Wellcome Trust Centre for Molecular Medicine Clinical Research Centre, University of Dundee, Tayside, U.K.
- 12Royal Infirmary of Edinburgh, Diabetes Centre, Edinburgh, Lothian, U.K.
- 13Western General Hospital, Diabetes Centre, Edinburgh, Lothian, U.K.
- 14SCI Diabetes Collaboration Ninewells Hospital and Medical School, University of Dundee Clinical Technology Centre, Dundee, Tayside, U.K.
- Corresponding author: Brian Kennon,
OBJECTIVES To establish the incidence of nontraumatic lower-extremity amputation (LEA) in people with diabetes in Scotland.
RESEARCH DESIGN AND METHODS This cohort study linked national morbidity records and diabetes datasets to establish the number of people with diabetes who underwent nontraumatic major and minor LEA in Scotland from 2004 to 2008.
RESULTS Two thousand three hundred eighty-two individuals with diabetes underwent a nontraumatic LEA between 2004 and 2008; 57.1% (n = 1,359) underwent major LEAs. The incidence of any LEA among persons with diabetes fell over the 5-year study period by 29.8% (3.04 per 1,000 in 2004 to 2.13 per 1,000 in 2008 P < 0.001). Major LEA rates decreased by 40.7% from 1.87 per 1,000 in 2004 to 1.11 per 1,000 in 2008 (P < 0.001).
CONCLUSIONS There has been a significant reduction in the incidence of LEA in persons with diabetes in Scotland between 2004 and 2008, principally explained by a reduction in major amputation.
- Received March 15, 2012.
- Accepted May 27, 2012.
- © 2012 by the American Diabetes Association.
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