The rate of foot and leg amputations among people with diabetes fell by as much as 36 percent in one four-year period, according to a study of patients at Veterans Affairs clinics. Taking patients' age and sex into account, amputations-major and minor-dropped from about seven per 1,000 patients in 2000 to between four and five per 1,000 by 2004. The latter figure is a reduction of around 36 percent, with the biggest decrease coming in above-the-knee amputations.
To gather its data, the VA tracked all patients at its clinics who had diabetes, including those who later underwent amputations paid for by Medicare. Experts are not sure why amputation rates declined over the four-year period, although some say that it might be due to earlier detection of diabetes and the introduction of aggressive medical therapies and lifestyle changes to treat it.
Amputations lie at the end of a long chain of diabetic side effects, include the deadening of nerves from inflammation, which can result in patients' inattention to serious limb injuries. Diabetes also slows the healing process, which can lead to ulcers so badly infected that gangrene sets in.
According to the National Institutes of Health, 65,000 people with diabetes underwent a foot or leg amputation in 2006, the latest year for which reliable figures are available. It is not clear if the trend detected in the VA figures can be applied to the U.S. population in general.
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